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Published on: September 15, 2023
Jugular bulb desaturation during off-pump coronary artery bypass surgery
Norikazu Miura1, Kenji Yoshitani, Masahiko Kawaguchi
1Department of Anesthesiology, National Cardiovascular Center, Suita, Osaka, Japan.
Journal of Anesthesia
|November 19, 2009
Summary
Off-pump coronary artery bypass grafting surgery can cause jugular bulb desaturation. Monitoring mixed venous oxygen saturation (S(VO2)), PaCO2, and CVP may help prevent cerebral desaturation during OPCAB.
Area of Science:
- Cardiovascular Surgery
- Neuroanesthesia
- Critical Care Medicine
Background:
- Off-pump coronary artery bypass grafting (OPCAB) is associated with jugular bulb desaturation.
- Jugular bulb desaturation during OPCAB may indicate postoperative cerebral injury.
- Routine jugular bulb oximetry is invasive and costly.
Purpose of the Study:
- To investigate the association between intraoperative hemodynamic compromise during OPCAB and jugular bulb desaturation.
- To identify hemodynamic and physiological predictors of jugular bulb desaturation in OPCAB patients.
Main Methods:
- Serial hemodynamic and physiological data collection during OPCAB.
- Arterial, mixed venous, and jugular venous bulb blood gas analyses.
- Multivariate linear and logistic regression analyses to assess correlations and predictors.
Main Results:
- Jugular bulb desaturation (
- Mixed venous oxygen saturation (S(VO2)), PaCO2, and CVP were significantly related to jugular bulb oxygen saturation (r=0.45).
- S(VO2) <=70%, PaCO2 <=40 mmHg, and CVP >=8 mmHg predicted jugular bulb desaturation.
Conclusions:
- Changes in S(VO2) and PaCO2 correlate with jugular bulb oxygen saturation during OPCAB.
- Specific thresholds for S(VO2), PaCO2, and CVP are significant predictors of jugular bulb desaturation.
- Maintaining normal S(VO2), PaCO2, and CVP may prevent cerebral desaturation in OPCAB patients.
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