title: Clinical evaluation of reflectance spectrophotometry for the measurement of gastric microvascular oxygen saturation in patients undergoing cardiopulmonary bypass.
abstract: OBJECTIVE
  To evaluate the impact of cardiopulmonary bypass (CPB) on gastric mucosal oxygen saturation assessed by reflectance spectrophotometry in patients undergoing coronary artery bypass graft surgery.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  A division of cardiothoracic anesthesia in a university hospital.
  
  
  METHODS
  Twelve consecutive patients undergoing CPB.
  
  
  METHODS
  Monitoring, anesthesia, surgical procedure, and CPB for the patients followed routine clinical protocol as established in the departments. Microvascular oxygen saturation in gastric mucosa was assessed by reflectance spectrophotometry before, during, and after CPB.
  
  
  RESULTS
  Gastric mucosal oxygen saturation averaged 65 +/- 7% (mean +/- SD) before CPB, decreased significantly to 57 +/- 9% during CPB (p < 0.01), and was 59 +/- 8% after CPB. These changes in regional oxygen saturation were not mirrored in variables of systemic oxygenation. Gastric mucosal oxygen saturation always showed instantaneous reactions to various surgical and pharmacologic interventions.
  
  
  CONCLUSIONS
  Reflectance spectrophotometry allowed the authors to assess gastric mucosal oxygen saturation with a high repetition rate, regardless of spontaneous circulation with pulsatile flow or nonpulsatile flow during CPB. This technique provided the means to monitor on-line the course of tissue oxygen saturation throughout the operative procedure. Reflectance spectrophotometry is an appropriate and sensitive assessment tool to monitor gastric mucosal oxygen saturation in patients undergoing CPB.
authors.affiliation: Department of Anesthesiology, Heinrich-Heine-University, Düsseldorf, Germany. arturfournell@compuserve.com
authors.forename: Artur
authors.initials: A
authors.lastname: Fournell
authors.forename: Lothar A
authors.initials: LA
authors.lastname: Schwarte
authors.forename: Thomas W L
authors.initials: TW
authors.lastname: Scheeren
authors.forename: Detlef
authors.initials: D
authors.lastname: Kindgen-Milles
authors.forename: Peter
authors.initials: P
authors.lastname: Feindt
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Loer
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass; D005260:Female; D005753:Gastric Mucosa / Q000098:blood supply*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D010108:Oxyhemoglobins / Q000378:metabolism; D011446:Prospective Studies; D013053:Spectrophotometry
chemical_list: D010108:Oxyhemoglobins; D010100:Oxygen