Document Detail


A european, multicenter, observational study to assess the value of gastric-to-end tidal PCO2 difference in predicting postoperative complications.
MedLine Citation:
PMID:  15281524     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Automated online tonometry displays a rapid, semicontinuous measurement of gastric-to-endtidal carbon dioxide (Pr-etCO2) as an index of gastrointestinal perfusion during surgery. Its use to predict postoperative outcome has not been studied in general surgery patients. We, therefore, studied ASA physical status III-IV patients operated on for elective surgery under general anesthesia and a planned duration of >2 h in a European, multicenter study. As each center was equipped with only 1 tonometric monitor, a randomization was performed if more than one patient was eligible the same day. Patients not monitored with tonometry were assessed only for follow-up. The main outcome measure was the assessment of postoperative functional recovery delay (FRD) on day 8. Among the 290 patients studied, 34% had FRD associated with a longer hospital stay. The most common FRDs were gastrointestinal (45%), infection (39%), and respiratory (35%). In those monitored with tonometry (n = 179), maximum Pr-etCO2 proved to be the best predictor increasing the probability of FRD from 34% for all patients to 65% at a cut-off of 21 mm Hg (2.8kPa) (sensitivity 0.27, specificity 0.92, positive predictive value 64%, negative predictive value 70%). We conclude that intraoperative Pr-etCO2 measurement may be a useful prognostic index of postoperative morbidity.
Authors:
Gilles Lebuffe; Benoît Vallet; Jukka Takala; Gary Hartstein; Maurice Lamy; Monty Mythen; Jan Bakker; David Bennett; Owen Boyd; Andrew Webb
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  99     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-29     Completed Date:  2004-08-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  166-72     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology 2, CHU de Lille, Lille, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Algorithms
Anesthesia
Carbon Dioxide / analysis,  blood,  metabolism*
Europe / epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Monitoring, Intraoperative
Postoperative Complications / diagnosis*,  epidemiology
Predictive Value of Tests
Prospective Studies
Risk Assessment
Stomach / metabolism*
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

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


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