Subcutaneous tissue oxygen tension after coronary revascularisation with and without cardiopulmonary bypass.

Abstract:

:Directly measured subcutaneous tissue oxygen tension reflects the adequacy of regional tissue oxygenation and influences wound infection and healing. We tested the hypothesis that off-pump coronary artery bypass would increase subcutaneous tissue oxygen tension by minimizing cardiopulmonary bypass-induced systemic inflammation. Ten consecutive patients scheduled for off-pump coronary artery bypass were compared with 10 undergoing conventional cardiopulmonary bypass. All patients had a tissue oxygen sensor implanted longitudinally into the subcutaneous tissue of the leg in the saphenous vein harvest wound. Data were collected from closure of the saphenous vein wound for 20 h postoperatively. Although more off-pump patients had only one coronary artery grafted, postoperative subcutaneous tissue oxygen tension was significantly higher in off-pump patients throughout the 20-h study. Absolute mean (SD) differences ranged from 2.3 kPa in the first 2 h [14.4 (2.3) vs. 12.1 (2.4) kPa in off-pump and cardiopulmonary bypass, respectively, p = 0.04] to 4.6 kPa at 8-10 h [14.0 (3.5) vs. 9.3 (2.7) kPa, p = 0.007]. In contrast, there were no significant differences in arterial oxygen tension values over this period. Mean arterial pressure and haemoglobin were transiently higher in off-pump patients at 8 h only. We conclude that postoperative subcutaneous tissue oxygen tension was higher for 20 h after off-pump compared with conventional cardiopulmonary bypass.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Cody C,Buggy DJ,Marsh B,Moriarity DC

doi

10.1111/j.1365-2044.2004.03608.x

subject

Has Abstract

pub_date

2004-03-01 00:00:00

pages

237-42

issue

3

eissn

0003-2409

issn

1365-2044

pii

3608

journal_volume

59

pub_type

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