| A european, multicenter, observational study to assess the value of gastric-to-end tidal PCO2 difference in predicting postoperative complications. | |
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MedLine Citation:
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PMID: 15281524 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 99 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-07-29 Completed Date: 2004-08-26 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 166-72 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology 2, CHU de Lille, Lille, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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124-38-9/Carbon Dioxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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