Advertisement

Critical Care

, 13:P228 | Cite as

Intraoperative central venous oxygen saturation and patient outcome in patients undergoing major abdominal surgery

  • R Rahman West
  • N Al-Subaie
  • A Addei
  • R Hagger
  • M Hamilton
  • M Grounds
  • A Rhodes
Poster presentation
  • 884 Downloads

Keywords

Central Venous Catheter Postoperative Outcome Urinary Catheter Arterial Lactate Operative Severity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

Low central venous saturation (ScvO2) in the post-operative period is associated with poor outcome. We examined whether intraoperative ScvO2 is a predictor of outcome based on the postoperative morbidity survey (POMS) and length of hospital stay. The POMS is a method for describing complications associated with major surgery [1]. It comprises a nine-point survey and provides a generic measure of short-term postoperative outcome.

Methods

Prospective ScvO2 values were collected from patients undergoing major abdominal surgery. This was done by intermittent sampling of blood obtained from the distal lumen of a central venous catheter placed in the jugular vein. The POMS was used to assess outcome on postoperative days 1, 3, 5, 8, 15 and 21 if applicable. To accommodate local practice, however, we excluded urinary catheter, pain and mobility from the POMS as it was not a true reflection of organ dysfunction in our study population. We evaluated other individual postsurgical complications as outlined in the POMS to establish whether intraoperative median, minimum and ΔScvO2 (end of surgery value minus start of surgery value) are related to outcome.

Results

Fifty-two patients (average age 67.8, SD 12.0) were included. The Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity revealed a predicted morbidity of 54.2% and mortality of 3.3%. The commonest complications were gastrointestinal and infection (58.7% and 19.2%, respectively). We found no correlation between median, minimum and ΔScvO2 with postoperative complication and length of hospital stay. However, ΔScvO2 for patients who exhibited postoperative complication on day 3 was significantly different from the patients who did not (P = 0.035) but the actual difference was only 2%. Minimum ScvO2 correlated weakly with high arterial lactate measured at the end of the procedure (Spearman r = 0.32, P = 0.025).

Conclusion

Intraoperative central venous saturation in patients undergoing major abdominal surgery is not related to postoperative outcome or length of hospital stay.

References

  1. 1.
    Bennett-Guerrero E, et al.: The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery. Anesth Analg 1999, 89: 514-519. 10.1097/00000539-199908000-00050PubMedGoogle Scholar

Copyright information

© West et al; licensee BioMed Central Ltd. 2009

This article is published under license to BioMed Central Ltd.

Authors and Affiliations

  • R Rahman West
    • 1
  • N Al-Subaie
    • 1
  • A Addei
    • 1
  • R Hagger
    • 1
  • M Hamilton
    • 1
  • M Grounds
    • 1
  • A Rhodes
    • 1
  1. 1.St George's HospitalLondonUK

Personalised recommendations