| Haemodynamic effects during endoscopic vein harvest of the saphenous vein for off-pump coronary artery bypass grafting surgery. | |
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MedLine Citation:
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PMID: 19842243 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Endoscopic vein harvest (EVH) for coronary artery bypass grafting surgery is performed with carbon dioxide (CO2) insufflation for visualization and dissection. The insufflated CO2 is rapidly absorbed into the body and may influence haemodynamics. However, the haemodynamic changes during EVH have not been clearly defined. This study evaluated the haemodynamic effects during EVH of the saphenous vein for off-pump coronary artery bypass grafting surgery (OPCAB). METHODS: After fixing the position for harvesting of the left internal mammary artery, EVH of the saphenous vein was performed at a maximum CO2 pressure of 12 mmHg and a flow of 3 l/min. The haemodynamic parameters were measured before and just after the end of endoscopic vein harvest. RESULTS: One hundred patients were studied. The end-tidal CO2 pressure (P(ET)CO2, 35.0 +/- 2.7 vs. 52.0 +/- 6.2 mmHg), partial pressure of arterial CO2 (PaCO2, 35.1 +/- 3.1 vs. 52.5 +/- 4.3 mmHg), mixed venous oxygen saturation (SvO2, 75.6 +/- 4.1 vs. 82.0 +/- 1.6%), cardiac index (2.7 +/- 0.6 vs. 3.3 +/- 0.6 l/min/m2), and cerebral oxygen saturation (ScO2, left: 63.5 +/- 7.9 vs. 73.3 +/- 8.4; right: 62.2 +/- 8.0 vs. 72.3 +/- 6.3%) differed significantly between before and after CO2 insufflation, whereas mean systemic blood pressure, mean pulmonary artery blood pressure, central venous pressure, heart rate, partial pressure of arterial oxygen, and peak inspiratory pressure did not differ significantly between before and after CO2 insufflation. CONCLUSIONS: EVH, at a maximum CO2 pressure of 12 mmHg and a flow of 3 l/min, of the saphenous vein for OPCAB was associated with hypercarbia and a tolerable range of hypercarbia (PaCO2 < 60 mmHg) increased the cardiac index and ScO2 without any complications. |
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Authors:
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Seong-Hyop Kim; Duk-Kyung Kim; Tae-Gyoon Yoon; Jeong-Ae Lim; Nam-Sik Woo; Tae-Yop Kim |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of anaesthesiology Volume: 26 ISSN: 1365-2346 ISO Abbreviation: Eur J Anaesthesiol Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-19 Completed Date: 2010-01-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8411711 Medline TA: Eur J Anaesthesiol Country: England |
Other Details:
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Languages: eng Pagination: 969-73 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology and Pain Medicine, School of Medicine, Konkuk University, Seoul, Korea. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Pressure / physiology Carbon Dioxide / administration & dosage* Central Venous Pressure Coronary Artery Bypass / methods* Endoscopy / methods Female Hemodynamics* Humans Insufflation Male Middle Aged Oxygen / metabolism Partial Pressure Prospective Studies Pulmonary Artery Saphenous Vein / transplantation* |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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