Year : 2018  |  Volume : 21  |  Issue : 4  |  Page : 371--375

Tissue oximetry during cardiac surgery and in the cardiac intensive care unit: A prospective observational trial


Benjamin J Heller1, Pranav Deshpande1, Joshua A Heller2, Patrick McCormick3, Hung-Mo Lin4, Ruiqi Huang4, Gregory Fischer3, Menachem M Weiner1 
1 Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, NY, USA
2 Department of Anesthesiology, Perioperative and Pain Medicine, Mount Sinai St. Luke's and Mount Sinai West, NY, USA
3 Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, NY, USA
4 Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, USA

Correspondence Address:
Benjamin J Heller
Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY 10029
USA

Background: Cerebral oximetry using near-infrared spectroscopy (NIRS) has well-documented benefits during cardiac surgery. The authors tested the hypothesis that NIRS technology can be used at other sites as a tissue oximeter during cardiac surgery and in the Intensive Care Unit (ICU). Aims: To establish feasibility of monitoring tissue oximetry during and after cardiac surgery, to examine the correlations between tissue oximetry values and cerebral oximetry values, and to examine correlations between oximetry values and mean arterial pressure (MAP) in order to test whether cerebral oximetry can be used as an index organ. Settings and Designs: A large, single-center tertiary care university hospital prospective observational trial of 31 patients undergoing cardiac surgery with cardiopulmonary bypass was conducted. Materials and Methods: Oximetry stickers were applied to both sides of the forehead, the nonarterial line forearm, and the skin above one paraspinal muscle. Data were collected from before anesthesia induction until extubation or for at least 24 h in patients who remained intubated. Statistical Analysis: Categorical variables were evaluated with Chi-square or Fisher's exact tests, while Wilcoxon rank-sum tests or student's t-tests were used for continuous variables. Results: The correlation between cerebral oximetry values and back oximetry values ranged from r = 0.37 to 0.40. The correlation between cerebral oximetry values and forearm oximetry values ranged from r = 0.11 to 0.13. None of the sites correlated with MAP. Conclusions: Tissue oximetry at the paraspinal muscle correlates with cerebral oximetry values while at the arm does not. Further research is needed to evaluate the role of tissue oximetry on outcomes such as acute renal failure, prolonged need for mechanical ventilation, stroke, vascular ischemic complications, prolonged ICU and hospital length of stay, and mortality in cardiac surgery.


How to cite this article:
Heller BJ, Deshpande P, Heller JA, McCormick P, Lin HM, Huang R, Fischer G, Weiner MM. Tissue oximetry during cardiac surgery and in the cardiac intensive care unit: A prospective observational trial.Ann Card Anaesth 2018;21:371-375


How to cite this URL:
Heller BJ, Deshpande P, Heller JA, McCormick P, Lin HM, Huang R, Fischer G, Weiner MM. Tissue oximetry during cardiac surgery and in the cardiac intensive care unit: A prospective observational trial. Ann Card Anaesth [serial online] 2018 [cited 2018 Dec 15 ];21:371-375
Available from: http://www.annals.in/article.asp?issn=0971-9784;year=2018;volume=21;issue=4;spage=371;epage=375;aulast=Heller;type=0