Document Detail

Haemodynamic effects during endoscopic vein harvest of the saphenous vein for off-pump coronary artery bypass grafting surgery.
MedLine Citation:
PMID:  19842243     Owner:  NLM     Status:  MEDLINE    
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.
Seong-Hyop Kim; Duk-Kyung Kim; Tae-Gyoon Yoon; Jeong-Ae Lim; Nam-Sik Woo; Tae-Yop Kim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  26     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-19     Completed Date:  2010-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  969-73     Citation Subset:  IM    
Department of Anaesthesiology and Pain Medicine, School of Medicine, Konkuk University, Seoul, Korea.
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MeSH Terms
Blood Pressure / physiology
Carbon Dioxide / administration & dosage*
Central Venous Pressure
Coronary Artery Bypass / methods*
Endoscopy / methods
Middle Aged
Oxygen / metabolism
Partial Pressure
Prospective Studies
Pulmonary Artery
Saphenous Vein / transplantation*
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

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