Clinical evaluation of reflectance spectrophotometry for the measurement of gastric microvascular oxygen saturation in patients undergoing cardiopulmonary bypass.
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.
Fournell
Artur
A
Department of Anesthesiology, Heinrich-Heine-University, Düsseldorf, Germany. arturfournell@compuserve.com
Schwarte
Lothar A
LA
Scheeren
Thomas W L
TW
Kindgen-Milles
Detlef
D
Feindt
Peter
P
Loer
Stephan A
SA
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
D010108:Oxyhemoglobins; D010100:Oxygen