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 | |
| State | Published - Feb 2004 |
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Keywords
- Anesthesia
- Bypass
- Cardiac output
- Cardiac surgery
- Off-pump
- Transesophageal echocardiography
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Cardiac Output Monitoring during Off-Pump Coronary Artery Bypass Grafting. / Grow, Matthew; Singh, Amrik; Fleming, Neal; Young, J Nilas; Watnik, Mitchell.
In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 18, No. 1, 02.2004, p. 43-46.Research output: Contribution to journal › Article
}
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 -