Jugular Venous Bulb Oxygen Saturation in Patients with Preexisting Diabetes Mellitus or Stroke during Normothermic Cardiopulmonary Bypass
Jugular Venous Bulb Oxygen Saturation in Patients with Preexisting Diabetes Mellitus or Stroke during Normothermic Cardiopulmonary Bypass
复制标题
常温心肺搭桥期间患有糖尿病或中风的患者的颈静脉球氧饱和度
DOI：
10.1097/00000542-200005000-00021
复制
发表时间：
2000
期刊：
影响因子：
8.8
通讯作者：
N. Fujita
中科院分区：
文献类型：
--
作者：
Y. Kadoi;S. Saito;F. Kawahara;F. Goto;R. Owada;N. Fujita
背景作者假设脑血管异常或代谢紊乱患者可能比无这些风险的患者更频繁地发生脑循环异常。目前的研究试图评估接受常温体外循环的既存糖尿病或卒中患者的颈静脉球血氧饱和度（SjvO 2）。方法选择39例择期行冠状动脉旁路移植术的患者，其中年龄匹配的对照组19例，糖尿病组10例，脑卒中组9例。将4.0-French光纤血氧饱和度导管插入右颈静脉球，连续监测颈内动脉血氧饱和度。在7个时间点测量血液动力学参数以及动脉和颈静脉血气：（1）麻醉诱导后、手术开始前，（2）心肺转流开始后，（3）转流开始后20 min，（4）转流开始后40 min，（5）转流开始后60 min，（6）旁路停止后，（7）运行结束时。结果3组患者平均动脉压、动脉血二氧化碳分压（PaCO 2）、血红蛋白浓度均无显著性差异。麻醉诱导后、手术前、体外循环开始后即刻、体外循环开始后60 min、体外循环结束后即刻和手术结束时，三组之间的SjvO 2值无差异。对照组与糖尿病组和脑卒中组在转流开始后20 min和40 min时有显著性差异（20 min：对照组62.2 ± 6.8%，糖尿病组48.4 ± 5.1%，脑卒中组45.9 ± 6.3%; 40 min：对照组62.6 ± 5.2%，糖尿病组47.1 ± 5.2%，脑卒中组48.8 ± 4.1% [均数±标准差]，P < 0.05）。此外，与手术开始前相比，糖尿病组和卒中组的数值在搭桥术开始后20分钟和40分钟降低。结论在常温体外循环中，糖尿病或脑卒中患者的SjvO 2值降低更常见。在具有脑血管疾病危险因素的患者中，常温转流期间的脑循环可能发生改变。
Background The authors hypothesized that patients with cerebrovascular abnormalities or metabolic disorders may experience abnormality in cerebral circulation more frequently than patients without these risks. The current study attempted to assess jugular venous bulb oxygen saturation (SjvO2) in patients with preexisting diabetes mellitus or stroke undergoing normothermic cardiopulmonary bypass. Methods Thirty-nine patients undergoing elective coronary artery bypass graft surgery were studied, including 19 age-matched control patients, 10 diabetic patients, and 9 patients with preexisting stroke A 4.0-French fiberoptic oximetry oxygen saturation catheter was inserted into the right jugular bulb to continuously monitor internal SjvO2. Hemodynamic parameters and arterial and jugular venous blood gases were measured at seven time points: (1) after the induction of anesthesia and before the start of surgery, (2) just after the beginning of cardiopulmonary bypass, (3) 20 min after the beginning of bypass, (4) 40 min after the beginning of bypass, (5) 60 min after the beginning of bypass, (6) just after the cessation of bypass, and (7) at the end of the operation. Results No significant differences were seen in mean arterial pressure, arterial carbon dioxide tension (PaCO2), or hemoglobin concentration among the three groups during the study. The SjvO2 value did not differ among the three groups after anesthesia induction and before surgery, just after the beginning of cardiopulmonary bypass, 60 min after the beginning of bypass, just after the end of bypass, or at the end of the operation. Significant differences between the control group and the diabetic and stroke groups were observed, however, at 20 min and 40 min after the beginning of bypass (at 20 min: control group 62.2 ± 6.8%, diabetes group 48.4 ± 5.1%, stroke group 45.9 ± 6.3%; at 40 min: control group 62.6 ± 5.2%, diabetes group 47.1 ± 5.2%, stroke group 48.8 ± 4.1% [values expressed as the mean ± SD];P < 0.05). Also, values in the diabetes and stroke groups were decreased at 20 min and 40 min after the beginning of bypass compared with before the start of surgery. Conclusions A reduced SjvO2 value was observed more frequently in patients with preexisting diabetes mellitus or stroke during normothermic cardiopulmonary bypass. It is possible that cerebral circulation during normothermic bypass is altered in patients with risk factors for cerebrovascular disorder.
影响因子：
37.8
作者：
M. Newman;R. Wolman;M. Kanchuger;K. Marschall;Christina T. Mora-Mangano;G. Roach;L. Smith;A. Aggarwal;N. Nussmeier;A. Herskowitz;D. Mangano
通讯作者：
M. Newman;R. Wolman;M. Kanchuger;K. Marschall;Christina T. Mora-Mangano;G. Roach;L. Smith;A. Aggarwal;N. Nussmeier;A. Herskowitz;D. Mangano
影响因子：
4.6
作者：
CROUGHWELL, ND;NEWMAN, MF;REVES, JG
通讯作者：
REVES, JG