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The Urethral Perfusion Index During Off-Pump Coronary Artery Bypass Surgery: An Observational Study.
Flick, Moritz; Rosenau, Lorenz; Sadtler, Hannah; Kouz, Karim; Krause, Linda; Joosten, Alexandre; Schulte-Uentrop, Leonie; Saugel, Bernd.
Afiliação
  • Flick M; Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Rosenau L; Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Sadtler H; Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Kouz K; Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Krause L; Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Joosten A; Department of Anesthesiology and Intensive Care, Université Paris-Sud, Paul Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France.
  • Schulte-Uentrop L; Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Saugel B; Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Outcomes Research Consortium, Cleveland, OH. Electronic address: bernd.saugel@gmx.de.
J Cardiothorac Vasc Anesth ; 38(2): 417-422, 2024 Feb.
Article em En | MEDLINE | ID: mdl-38114369
ABSTRACT

OBJECTIVES:

The IKORUS system (Vygon, Écouen, France) allows continuous monitoring of the urethral perfusion index (uPI) using a photoplethysmographic sensor mounted near the base of the balloon of a dedicated urinary catheter. We aimed to test the hypothesis that the uPI decreases during off-pump coronary artery bypass (OPCAB) surgery and to investigate the relationship between the uPI and macrocirculatory variables.

DESIGN:

Prospective observational study.

SETTING:

University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

PARTICIPANTS:

Twenty patients having OPCAB surgery.

INTERVENTIONS:

None. MEASUREMENTS AND MAIN

RESULTS:

The primary endpoint was changes in the uPI during OPCAB surgery. We additionally investigated associations between the uPI and cardiac output, mean arterial pressure, heart rate, and point-of-care variables. Twenty patients with 24,137 uPI measurements were included. Overall, there was a high interindividual variability in the uPI. Compared with the preparation phase (during which the median [interquartile range] uPI was 7.7 [5.6-12.0]), the uPI decreased by 14% (95% CI 13%-15%) during the bypass grafting phase, by 35% (95% CI 34%-36%) during the cardiac positioning phase, and by 7% (95% CI 6%-9%) during hemostasis. There was no clinically important association between uPI and either cardiac output, mean arterial pressure, or heart rate.

CONCLUSIONS:

The uPI decreases during OPCAB surgery, specifically during the cardiac positioning phase. There was no clinically important association between uPI and either cardiac output, mean arterial pressure, or heart rate. It, therefore, remains to be determined whether intraoperative uPI decreases are clinically important, reflect alterations in intra-abdominal tissue perfusion that are not reflected by systemic macrohemodynamics, and can help clinicians guide therapeutic interventions.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Ponte de Artéria Coronária sem Circulação Extracorpórea Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Ponte de Artéria Coronária sem Circulação Extracorpórea Idioma: En Ano de publicação: 2024 Tipo de documento: Article