title: Intraoperative baseline oxygen consumption as a prognostic factor in emergency open abdominal surgery.
abstract: BACKGROUND
  A new anesthesia system, the E-CAIOVX (GE Healthcare) enables the continuous monitoring of oxygen consumption (VO2) and carbon dioxide elimination (VCO2) during the surgical operation. The aim of this study was to evaluate the prognostic role of intraoperative baseline VO2 and VCO2 in an emergency open abdominal operation.
  
  
  METHODS
  A total of 103 patients who had an emergency open abdominal operation were enrolled in the study. VO2 and VCO2 were continuously measured from the induction of anesthesia to the end of the operation.
  
  
  RESULTS
  There were significant correlations between intraoperative baseline VO2 and body surface area (BSA; P < .001, r = 0.68), VO2 and tidal volume (P < .001, r = 0.59), and VO2 and baseline body temperature (P < .0001, r = 0.49). Also, there were significant correlations between intraoperative baseline VCO2 and BSA (P < .001, r = 0.70), VCO2 and tidal volume (P < .001, r = 0.70), and VCO2 and body temperature (P < .001, r = 0.41). Fifteen (14.6%) of the 103 patients died within 4 months after the operation without having been discharged from hospital. Baseline VO2/BSA was higher in surviving patients (123.7 ± 23.6 mL/min ∙ m(2)) than the deceased (103.8 ± 15.6 mL/min ∙ m(2); P = .002). There was no significant difference in baseline VCO2/BSA levels between surviving (106.2 ± 20.1 mL/min ∙ m(2)) and deceased patients (99.4 ± 21.4 mL/min ∙ m(2)). In multivariate analysis, baseline body temperature lower than 36.2°C (P = .02), serum albumin less than 3.0 g/dL (P = .002), and baseline VO2/BSA less than 111.9 mL/min ∙ m(2) (P = .03) were independent factors.
  
  
  CONCLUSIONS
  Baseline low VO2/BSA less than 111.9 mL/min ∙ m(2) was one of the poor predictors for the prognosis of an emergency open abdominal surgery.
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, Yatsushiro, Kumamoto, Japan; Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, Yatsushiro, Kumamoto, Japan. Electronic address: kuramoto@kumamoto-gh.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kuramoto
authors.affiliation: Department of Anesthesia, Kumamoto General Hospital, Japan Community Health Care Organization, Yatsushiro, Kumamoto, Japan.
authors.forename: Hironari
authors.initials: H
authors.lastname: Tanimoto
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, Yatsushiro, Kumamoto, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, Yatsushiro, Kumamoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikeshima
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, Yatsushiro, Kumamoto, Japan.
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Kitano
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, Yatsushiro, Kumamoto, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kuroda
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, Yatsushiro, Kumamoto, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Shimada
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000368:Aged; D000758:Anesthesia / Q000379:methods; D000776:Anesthesiology / Q000295:instrumentation*; D001831:Body Temperature; D002245:Carbon Dioxide / Q000378:metabolism; D004632:Emergency Medical Services; D005260:Female; D005705:Gallbladder Diseases / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007416:Intestinal Perforation / Q000378:metabolism / Q000401:mortality / Q000601:surgery*; D007430:Intraoperative Care / Q000379:methods*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000401:mortality / Q000601:surgery*; D013990:Tidal Volume
chemical_list: D002245:Carbon Dioxide
keywords: Emergency abdominal operation; VCO(2); VO(2)