Abstract

COMBINED CENTRAL VENOUS OXYGEN SATURATION AND LACTATE AS MARKERS OF OCCULT HYPOPERFUSION AND OUTCOME FOLLOWING CARDIAC SURGERY

Santosh Devi(MD), Sheikh Irshad Ahmad (Associate Professor), Abdul Waheed Mir (Assistant Professor), Showkat Gurcoo (Professor), Tantry Tariq Gani(MD)* and Tanveera Gani

Abstract

Background: Routinely monitored parameters may not reliably detect perfusion abnormalities. However, ScvO2 & lactate levels can detect occult hypoperfusion and identify patients at risk for complications. Objective: This study was aimed to examine the occurrence of postoperative occult hypoperfusion, determined by the combination of low ScvO2 & elevated lactate & its effect on outcomes after cardiac surgery. Study design: Prospective observational study. Setting: Tertiary care hospital. Patient population: Patients undergoing different cardiac surgeries under cardiopulmonary bypass. Results: The study included 100 patients. Postoperative ScvO2 & arterial lactate were obtained on arrival to the ICU & at 24 hours after ICU admission. Mod erate GTH was defined as ScvO2 65 mmHg, CVP>8 mmHg & urine output >0.5mL/kg/h. 37 patients had occult hypoperfusion on arrival to Cardiac Surgical ICU. Patients with occult hypoperfusion on ICU admission had significantly longer ICU/Hospital LOS & ventilation time (p

Keywords: Routinely monitored hypoperfusion after cardiac surgery.