Correlation between regional tissue perfusion saturation and lactate level during cardiopulmonary bypass

Yoon Sook Lee, Woon Young Kim, Ji Won Yoo, Hyun Don Jung, Too Jae Min

Research output: Contribution to journalArticle

Abstract

Background: Cardiopulmonary bypass (CPB) can cause systemic hypoperfusion, which remains undetected by routine monitoring of physiological parameters. Noninvasive tissue perfusion monitoring offers a clinical benefit by detecting low systemic perfusion. In this study, we tried to evaluate whether regional tissue perfusion saturation reflects systemic hypoperfusion during CPB. Methods: This retrospective study included 29 patients with American Society of Anesthesiologists physical status II–III, who required cardiac surgery with CPB. We evaluated the correlations of serum lactate and delivery oxygen with organ perfusion values of peripheral tissue oxygen saturation and cerebral oxygen saturation. Data were recorded at different stages of CPB: T1 (pre-CPB), T2 (cooling), T3 (hypothermia), T4 (rewarming), and T5 (post-CPB). Results: Lactate levels were elevated after CPB and up to weaning (P < 0.05). The levels of peripheral and tissue oxygen saturation decreased after the start of CPB (P < 0.05). Lactate levels were negatively correlated with peripheral tissue oxygen saturation levels at T4 (R = −0.384) and T5 (R = −0.370) and positively correlated with cerebral oxygen saturation at T3 (R = 0.445). Additionally, delivery oxygen was positively correlated with peripheral tissue oxygen saturation at T4 (R = 0.466). Conclusions: In this study, we demonstrated that peripheral tissue oxygen saturation can be a reliable tool for monitoring systemic hypoperfusion during CPB period. We also believe that peripheral tissue oxygen saturation is a valuable marker for detecting early stages of hypoperfusion during cardiac surgery.

Original languageEnglish
Pages (from-to)361-367
Number of pages7
JournalKorean Journal of Anesthesiology
Volume71
Issue number5
DOIs
Publication statusPublished - 2018 Oct 1

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Keywords

  • Cardiopulmonary bypass
  • Hypoperfusion
  • Serum lactate level
  • Tissue oxygen saturation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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