Increasing mean arterial pressure improves jugular venous oxygen saturation in patients with and without preexisting stroke during normothermic cardiopulmonary bypass.
OBJECTIVE
To examine whether increasing mean arterial pressure (MAP) with the administration of phenylephrine would improve internal jugular venous oxygen saturation (SjvO2) during normothermic cardiopulmonary bypass (CPB) in patients with preexisting stroke.


METHODS
Prospective, controlled study.


METHODS
Cardiovascular center and university hospital.


METHODS
17 patients with preexisting stroke who were scheduled for elective coronary artery bypass graft (CABG) surgery, and a control group of 17 age-matched patients without preexisting stroke.


METHODS
After the induction of anesthesia, a fiberoptic oximetry catheter was inserted into the right jugular bulb to monitor SjvO2. After measuring the baseline partial pressure of the arterial and jugular venous blood gases and cardiovascular hemodynamic values immediately before the start of the study protocol, MAP was increased by the repeated administration of a 10 microg bolus of phenylephrine, until it reached 200% of baseline values.


METHODS
Partial pressure of the arterial and jugular venous blood gases and cardiovascular hemodynamic values before and after the treatment were recorded.


RESULTS
There was no significant difference between the groups in SjvO2 values at baseline (Mann-Whitney U test: p = 0.22). SjvO2 values in both groups were increased after the administration of phenylephrine (SjvO2 values in the control group: 60 +/- 5%, SjvO2 values in the stroke group: 57 +/- 5%). There was no significant difference between the stroke and control groups in SjvO2 values after the administration of phenylephrine (Mann-Whitney U test: p = 0.08).


CONCLUSIONS
Increasing MAP improves SjvO2 in patients with or without preexisting stroke during normothermic CPB.
D000368:Aged; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000502:physiology*; D002315:Cardiopulmonary Bypass; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D010656:Phenylephrine / Q000494:pharmacology; D011446:Prospective Studies; D020521:Stroke / Q000503:physiopathology*; D014662:Vasoconstrictor Agents / Q000494:pharmacology
D014662:Vasoconstrictor Agents; D010656:Phenylephrine; D010100:Oxygen