title: Blood pressure and free flap oxygenation in head and neck cancer patients.
abstract: CONCLUSIONS
  This study suggests that although oxygen partial pressure in tissue (p(ti)O(2)) measurement is a feasible method for continuous postoperative monitoring of free flaps, low correlation between blood pressure (BP) and p(ti)O(2) might predict compromised overall outcome. Thus, it is of utmost importance to keep the BP optimal for adequate perfusion of re-anastomosed tissue transfers.
  
  
  OBJECTIVE
  Optimal BP is an important factor in assuring adequate blood flow in a free flap. Tissue oxygenation in free flaps as a postoperative monitoring target is in routine clinical use in some clinics. Correlation between p(ti)O(2) and systemic BP was investigated.
  
  
  METHODS
  Ten consecutive patients underwent resection of head and neck squamous cell carcinoma followed by microvascular reconstruction with a free microvascular flap. P(ti)O(2) of each flap was continuously monitored for 3 postoperative days with a polarographic measurement system. BP was measured invasively and continuously during the operation and during the first postoperative day at the intensive care unit. The correlation coefficient between p(ti)O(2) and BP was analysed.
  
  
  RESULTS
  The correlation coefficient between p(ti)O(2) and BP was relatively high in all patients with uneventful flap survival (r (mean) = 0.63, n = 5). In flaps with haemodynamic problems or compromised flap vitality the correlation appeared low (r(mean) = -0.02, n = 5).
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Finland. aleksi.schrey@tyks.fi
authors.forename: Aleksi
authors.initials: A
authors.lastname: Schrey
authors.forename: Ilpo
authors.initials: I
authors.lastname: Kinnunen
authors.forename: Tero
authors.initials: T
authors.lastname: Vahlberg
authors.forename: Heikki
authors.initials: H
authors.lastname: Minn
authors.forename: Reidar
authors.initials: R
authors.lastname: Grénman
authors.forename: Markku
authors.initials: M
authors.lastname: Taittonen
authors.forename: Kalle
authors.initials: K
authors.lastname: Aitasalo
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000502:physiology*; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D009367:Neoplasm Staging; D010101:Oxygen Consumption / Q000502:physiology*; D011184:Postoperative Period; D011446:Prospective Studies; D012039:Regional Blood Flow; D016896:Treatment Outcome