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Analysis of factors related to jugular venous oxygen saturation during cardiopulmonary bypass
1Department of Anesthesiology, Kumamoto Chuo Hospital, Kumamoto City, Japan.
Objective:
To investigate preoperative clinical conditions and/or intraoperative physiologic variables related to jugular venous oxygen saturation (SjO2) during cardiopulmonary bypass (CPB).
Design:
Prospective study.
Setting:
General hospital, single institution.
Participants:
One hundred forty patients (52 women, 88 men) who underwent coronary artery bypass grafting.
Measurements And Main Results:
The authors measured SjO2 at five times during surgery. Multiple stepwise regression analysis showed a significant correlation of SjO2 with (1) arterial carbon dioxide partial pressure (PaCO2) before CPB (standard regression coefficient [(SC)] = 0.435), (2) cerebral perfusion pressure (CPP) during initiation of CPB (SC = 0.259), (3) PaCO2, tympanic temperature (TT), bubble oxygenator, and cerebral small infarctions (CSIs) during hypothermic CPB (SC = 0.507, -0.237, -0.192, and -0.189, respectively), (4) CPP, PaCO2, CSIs, and bubble oxygenator during rewarming (SC = 0.476, 0.294, -0.220, and -0.189, respectively), and (5) PaCO2 after CPB (SC = 0.480; p < 0.01). Correlation coefficients between SjO2 and CPP during rewarming were 0.40 (0.46 without CSI and 0.37 with CSI; p < 0.01). These results indicate that the relationship between CPP and SjO2 was significant in patients with CPP less than 40 mmHg during rewarming.
Conclusion:
During rewarming, when cerebral perfusion and oxygen demand change abruptly, but not during stable hypothermic CPB, CPP was a significant factor related to sjO2.