Time course of changes in jugular venous oxygen saturation during hypothermic or normothermic cardiopulmonary bypass in patients with diabetes mellitus.
BACKGROUND
Preexisting diabetic mellitus is a risk factor determining postoperative neurological disorders. The present study assesses the effects of normothermic and hypothermic cardiopulmonary bypass (CPB) on jugular venous oxygen saturation (SjvO2)in patients with preexisting diabetic mellitus.


METHODS
Sixteen diabetic patients who underwent elective coronary artery bypass grafting surgery were randomly divided into two groups: Group DN (n=8, diabetic patients) underwent normothermic CPB (>35 degrees C), and group DH (n=8, diabetic patients) underwent hypothermic CPB (32 degrees C). Controls were 16 age-matched non-diabetic patients (normothemic group, CN: n=8; hypothemic group, CH: n=8). A 4.0 F fiberoptic oximetry oxygen saturation catheter was inserted into the right jugular bulb to continuously monitor SjvO2 values. Hemodynamic parameters and arterial and jugular venous blood gases were measured seven times.


RESULTS
Cerebral desaturation, which was defined as SjvO2 values below 50%, was observed during normothermic CPB in diabetic patients (at the onset of CPB: 46+/-3%, at 20 min after onset of CPB: 49+/-3%, means+/-SD, respectively). No cerebral desaturation occurred in diabetic and control patients during hypothermic CPB.


CONCLUSIONS
Patients with preexisting diabetes mellitus experienced cerebral desaturation during normothermic CPB.
Kadoi
Y
Y
Department of Anesthesiology and Reanimatology, Gunma University, School of Medicine, Gunma, Japan. kadoi@med.gunma-u.ac.jp
Saito
S
S
Goto
F
F
Someya
T
T
Kamiyashiki
S
S
Fujita
N
N
D000368:Aged; D001784:Blood Gas Analysis; D002314:Cardioplegic Solutions; D002315:Cardiopulmonary Bypass; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006400:Hematocrit; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007036:Hypothermia, Induced; D007601:Jugular Veins / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010100:Oxygen / Q000097:blood*; D018570:Risk Assessment
D002314:Cardioplegic Solutions; D010100:Oxygen