Cardiac Output Monitoring during Off-Pump Coronary Artery Bypass Grafting

Matthew Grow; Amrik Singh; Neal Fleming; J Nilas Young; Mitchell Watnik

doi:10.1053/j.jvca.2003.10.009

Cardiac Output Monitoring during Off-Pump Coronary Artery Bypass Grafting

Matthew Grow, Amrik Singh, Neal Fleming, J Nilas Young, Mitchell Watnik

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Objective: To evaluate and compare monitors of cardiac output during repositioning and stabilization of the heart for off-pump coronary artery bypass (OPCAB) surgery. Design: Prospective, observational, clinical study. Setting: University teaching hospital. Participants: Consecutive patients scheduled to undergo elective OPCAB (n = 19). Interventions: Monitoring, induction, and anesthesia followed a routine protocol for coronary artery bypass patients. This included the use of transesophageal echocardiography (TEE) and pulmonary artery catheter placement. Measurements and Main Results: After positioning and stabilization for OPCAB surgery, the changes in descending aortic flow velocity (VTI) times heart rate (HR) and the mixed venous oxygen saturation (SvO₂) could be used to predict the changes in thermodilution cardiac output (TDCO) using the following model: ΔTDCO _(calc) = -13.15 + 0.35 (ΔVTI*HR) + 0.61 (ΔSvO ₂) where Δ indicates the percentage change from baseline values. The changes in mean arterial pressure, mean pulmonary artery pressure, and continuous cardiac output did not correlate with the changes in TDCO. Conclusion: The use of the VTI*HR, as determined by TEE, in addition to the SvO₂ can strengthen clinical decision making during repositioning and stabilization of the heart during OPCAB. Changes in the VTI*HR and SvO₂ can be used as surrogate markers for changes in CO during OPCAB surgery.

Original language	English (US)
Pages (from-to)	43-46
Number of pages	4
Journal	Journal of Cardiothoracic and Vascular Anesthesia
Volume	18
Issue number	1
DOIs	https://doi.org/10.1053/j.jvca.2003.10.009
State	Published - Feb 2004

Keywords

Anesthesia
Bypass
Cardiac output
Cardiac surgery
Off-pump
Transesophageal echocardiography

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

Access to Document

10.1053/j.jvca.2003.10.009

Fingerprint Dive into the research topics of 'Cardiac Output Monitoring during Off-Pump Coronary Artery Bypass Grafting'. Together they form a unique fingerprint.

Cite this

@article{379c458be56f4dc19922175db679d651,

title = "Cardiac Output Monitoring during Off-Pump Coronary Artery Bypass Grafting",

abstract = "Objective: To evaluate and compare monitors of cardiac output during repositioning and stabilization of the heart for off-pump coronary artery bypass (OPCAB) surgery. Design: Prospective, observational, clinical study. Setting: University teaching hospital. Participants: Consecutive patients scheduled to undergo elective OPCAB (n = 19). Interventions: Monitoring, induction, and anesthesia followed a routine protocol for coronary artery bypass patients. This included the use of transesophageal echocardiography (TEE) and pulmonary artery catheter placement. Measurements and Main Results: After positioning and stabilization for OPCAB surgery, the changes in descending aortic flow velocity (VTI) times heart rate (HR) and the mixed venous oxygen saturation (SvO2) could be used to predict the changes in thermodilution cardiac output (TDCO) using the following model: ΔTDCO (calc) = -13.15 + 0.35 (ΔVTI*HR) + 0.61 (ΔSvO 2) where Δ indicates the percentage change from baseline values. The changes in mean arterial pressure, mean pulmonary artery pressure, and continuous cardiac output did not correlate with the changes in TDCO. Conclusion: The use of the VTI*HR, as determined by TEE, in addition to the SvO2 can strengthen clinical decision making during repositioning and stabilization of the heart during OPCAB. Changes in the VTI*HR and SvO2 can be used as surrogate markers for changes in CO during OPCAB surgery.",

keywords = "Anesthesia, Bypass, Cardiac output, Cardiac surgery, Off-pump, Transesophageal echocardiography",

author = "Matthew Grow and Amrik Singh and Neal Fleming and Young, {J Nilas} and Mitchell Watnik",

year = "2004",

month = feb,

doi = "10.1053/j.jvca.2003.10.009",

language = "English (US)",

volume = "18",

pages = "43--46",

journal = "Journal of Cardiothoracic and Vascular Anesthesia",

issn = "1053-0770",

publisher = "W.B. Saunders Ltd",

number = "1",

}

TY - JOUR

T1 - Cardiac Output Monitoring during Off-Pump Coronary Artery Bypass Grafting

AU - Grow, Matthew

AU - Singh, Amrik

AU - Fleming, Neal

AU - Young, J Nilas

AU - Watnik, Mitchell

PY - 2004/2

Y1 - 2004/2

N2 - Objective: To evaluate and compare monitors of cardiac output during repositioning and stabilization of the heart for off-pump coronary artery bypass (OPCAB) surgery. Design: Prospective, observational, clinical study. Setting: University teaching hospital. Participants: Consecutive patients scheduled to undergo elective OPCAB (n = 19). Interventions: Monitoring, induction, and anesthesia followed a routine protocol for coronary artery bypass patients. This included the use of transesophageal echocardiography (TEE) and pulmonary artery catheter placement. Measurements and Main Results: After positioning and stabilization for OPCAB surgery, the changes in descending aortic flow velocity (VTI) times heart rate (HR) and the mixed venous oxygen saturation (SvO2) could be used to predict the changes in thermodilution cardiac output (TDCO) using the following model: ΔTDCO (calc) = -13.15 + 0.35 (ΔVTI*HR) + 0.61 (ΔSvO 2) where Δ indicates the percentage change from baseline values. The changes in mean arterial pressure, mean pulmonary artery pressure, and continuous cardiac output did not correlate with the changes in TDCO. Conclusion: The use of the VTI*HR, as determined by TEE, in addition to the SvO2 can strengthen clinical decision making during repositioning and stabilization of the heart during OPCAB. Changes in the VTI*HR and SvO2 can be used as surrogate markers for changes in CO during OPCAB surgery.

AB - Objective: To evaluate and compare monitors of cardiac output during repositioning and stabilization of the heart for off-pump coronary artery bypass (OPCAB) surgery. Design: Prospective, observational, clinical study. Setting: University teaching hospital. Participants: Consecutive patients scheduled to undergo elective OPCAB (n = 19). Interventions: Monitoring, induction, and anesthesia followed a routine protocol for coronary artery bypass patients. This included the use of transesophageal echocardiography (TEE) and pulmonary artery catheter placement. Measurements and Main Results: After positioning and stabilization for OPCAB surgery, the changes in descending aortic flow velocity (VTI) times heart rate (HR) and the mixed venous oxygen saturation (SvO2) could be used to predict the changes in thermodilution cardiac output (TDCO) using the following model: ΔTDCO (calc) = -13.15 + 0.35 (ΔVTI*HR) + 0.61 (ΔSvO 2) where Δ indicates the percentage change from baseline values. The changes in mean arterial pressure, mean pulmonary artery pressure, and continuous cardiac output did not correlate with the changes in TDCO. Conclusion: The use of the VTI*HR, as determined by TEE, in addition to the SvO2 can strengthen clinical decision making during repositioning and stabilization of the heart during OPCAB. Changes in the VTI*HR and SvO2 can be used as surrogate markers for changes in CO during OPCAB surgery.

KW - Anesthesia

KW - Bypass

KW - Cardiac output

KW - Cardiac surgery

KW - Off-pump

KW - Transesophageal echocardiography

UR - http://www.scopus.com/inward/record.url?scp=1242297508&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1242297508&partnerID=8YFLogxK

U2 - 10.1053/j.jvca.2003.10.009

DO - 10.1053/j.jvca.2003.10.009

M3 - Article

C2 - 14973798

AN - SCOPUS:1242297508

VL - 18

SP - 43

EP - 46

JO - Journal of Cardiothoracic and Vascular Anesthesia

JF - Journal of Cardiothoracic and Vascular Anesthesia

SN - 1053-0770

IS - 1

ER -