Document Detail


Endoluminal pulse oximetry combined with tonometry to monitor the perfusion of the sigmoid during and after resection of abdominal aortic aneurysm.
MedLine Citation:
PMID:  9158125     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early detection of colonic ischaemia after aortic grafting is essential if mortality is to be decreased when this complication develops. The aim of this study was to determine changes in the sigmoid colon during and after abdominal aortic grafting using endoluminal pulse oximetry (SmO2). Oxygen saturation was measured on the mucosa (SmO2) and serosa (SsO2) of 20 sequential patients undergoing elective surgery for abdominal aortic aneurysm; intramural pHi was also measured. Initially, all patients had a normal SmO2 in the sigmoid; however, before cross-clamping eight patients had a reduction in the SmO2. The pulse curve disappeared immediately after cross-clamping in 15 patients, with only five still showing a pulse curve in the sigmoid colon. Before declamping, 13 patients regained their pulse curve. The intraluminal pHi showed a large interindividual variation (2 S.D. approximately 0.4). Patients were classified into three groups according to SmO2: group A, no pulse; group B, diminished saturation (< 90%); and group C, normal saturation (> or = 90%). There was significant correlation with the pHi after cross-clamping in all groups. One patient who developed ischaemia of the sigmoid colon demonstrated a prolonged reduction in the SmO2, a decreased perioperative pHi, and an increased oxygen saturation in the inferior mesenteric vein during cross-clamping.
Authors:
A C Vahl; E N Ozkaynak-Yilmaz; S H Nauta; G J Scheffer; R J Felt-Bersma; H L Brom; J A Rauwerda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular surgery (London, England)     Volume:  5     ISSN:  0967-2109     ISO Abbreviation:  Cardiovasc Surg     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-08-07     Completed Date:  1997-08-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9308765     Medline TA:  Cardiovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  65-70     Citation Subset:  IM    
Affiliation:
Institute for Cardiovascular Research (Department of Vascular Surgery), Free University Hospital at Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Aneurysm, Abdominal / surgery*
Colon, Sigmoid / blood supply*
Female
Humans
Hydrogen-Ion Concentration
Intestinal Mucosa / blood supply
Intraoperative Complications / diagnosis,  prevention & control*
Ischemia / diagnosis,  prevention & control*
Male
Middle Aged
Monitoring, Intraoperative / instrumentation*
Oximetry / instrumentation*
Postoperative Complications / diagnosis,  prevention & control
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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