Cardiac Output Monitoring during Off-Pump Coronary Artery Bypass Grafting

Research output: Contribution to journalArticle

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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 languageEnglish (US)
Pages (from-to)43-46
Number of pages4
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume18
Issue number1
DOIs
StatePublished - Feb 2004

Fingerprint

Off-Pump Coronary Artery Bypass
Coronary Artery Bypass
Cardiac Output
Thermodilution
Heart Rate
Transesophageal Echocardiography
Pulmonary Artery
Carbon Monoxide
Teaching Hospitals
Observational Studies
Arterial Pressure
Catheters
Anesthesia
Biomarkers
Oxygen
Pressure

Keywords

  • Anesthesia
  • Bypass
  • Cardiac output
  • Cardiac surgery
  • Off-pump
  • Transesophageal echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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",
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AU - Singh, Amrik

AU - Fleming, Neal

AU - Young, J Nilas

AU - Watnik, Mitchell

PY - 2004/2

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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.

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