Postoperative myocardial ischaemia: temporal association with nocturnal hypoxaemia.
Three patients presenting for elective aortic surgery were studied before operation and for up to 3 days after operation with ambulatory electrocardiographic monitoring and nocturnal pulse oximetry. Supplementary oxygen was administered for the first 2 days after operation and withdrawn on the 3rd morning after operation. Heart rate remained increased for the first 3 days after operation. Two patients developed episodes of myocardial ischaemia during the first 48 h after operation while their arterial oxygen saturation remained greater than 90%. On the third day, and during the third night after operation, both the severity and duration of myocardial ischaemia increased markedly, associated with arterial hypoxaemia. A temporal relationship between decreases in oxygen saturation and fluctuations in ST segment level were observed in the three patients.
Reeder
M K
MK
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Headington, Oxford.
Muir
A D
AD
Foëx
P
P
Goldman
M D
MD
Loh
L
L
Smart
D
D
D000368:Aged; D003327:Coronary Disease / Q000209:etiology*; D015716:Electrocardiography, Ambulatory; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D008297:Male; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy; D011183:Postoperative Complications / Q000209:etiology*; D013997:Time Factors
D010100:Oxygen