Predictive role of regional thigh tissue oxygen saturation monitoring during cardiopulmonary bypass in lung injury after cardiac surgery.

Publisher: Springer Verlag Country of Publication: Japan NLM ID: 9815648 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1619-0904 (Electronic) Linking ISSN: 14347229 NLM ISO Abbreviation: J Artif Organs Subsets: MEDLINE

Original Publication: Tokyo : Springer Verlag, c1998-

Cardiopulmonary Bypass*/adverse effects ; Oxygen Saturation*/physiology ; Cardiac Surgical Procedures*/adverse effects ; Thigh*/surgery ; Spectroscopy, Near-Infrared*/methods; Humans ; Male ; Female ; Middle Aged ; Aged ; Postoperative Complications/diagnosis ; Postoperative Complications/etiology ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/diagnosis ; Lung Injury/etiology ; Lung Injury/metabolism ; Lung Injury/diagnosis

Acute respiratory distress syndrome (ARDS) is a serious complication following cardiac surgery mainly associated with the use of cardiopulmonary bypass (CPB), which could increase the risk of mortality and morbidity. This study investigated the association of regional oxygen saturation (rSO 2 ) during CPB with postoperative outcomes, including respiratory function. Patients who underwent cardiac surgery with CPB from 2015 to 2019 were included. Near-infrared spectroscopy was used to monitor rSO 2 at the forehead, abdomen, and thighs throughout the surgery. Postoperative markers associated with CPB were assessed for correlations with PaO 2 /FiO 2 (P/F) ratios at intensive care unit (ICU) admission. Postoperative lung injury (LI) was defined as moderate or severe ARDS based on the Berlin criteria, and its incidence was 29.9% (20/67). On multiple regression analysis, the following were associated with P/F ratios at ICU admission: vasoactive-inotropic scores at CPB induction (P = 0.03), thigh rSO 2 values during CPB (P = 0.04), and body surface area (P < 0.001). A thigh rSO 2 of 71% during CPB was significantly predictive of postoperative LI with an area under the curve of 0.71 (P = 0.03), sensitivity of 0.70, and specificity of 0.68. Patients with postoperative LI had longer ventilation time and ICU stays. Thigh rSO 2 values during CPB were a potential predictor of postoperative pulmonary outcomes.
Competing Interests: Declarations. Conflict of interest: The authors have no competing interests to declare that are relevant to the content of this article. Ethical approval: This retrospective study was approved by the Institutional Review Board (IRB) of Kitasato University Hospital on October 23, 2019 (approval no. B19-112). Consent to participate: Informed consent was obtained using an opt-out approach on the websites approved by the IRB.
(© 2024. The Japanese Society for Artificial Organs.)

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23K15545 JSPS Kaenhi

Keywords: Cardiopulmonary bypass; Near-infrared spectroscopy; Postoperative acute respiratory distress syndrome; Regional oxygen saturation monitoring

Date Created: 20240318 Date Completed: 20241121 Latest Revision: 20241121

20241122

10.1007/s10047-024-01438-y

38498214