Oxygen delivery monitoring under cardiopulmonary bypass : what implication on postoperative morbidity and mortality ?

Abstract

Introduction: The standard control parameters of cardiopulmonary bypass (CPB) currently used in Tunisia are replaced in Western countries by the concept of "goal-directed-perfusion" requiring oxygen delivery (DO2) minimum at 270ml / min / m2.
Aim: In this study, we explored the association between the DO2 and the postoperative morbidity and mortality.
Methods: This is a cross-sectional and retrospective observational study including a series of 50 patients operated on for myocardial revascularization under CPB.
Results: We noticed a significant correlation between starting DO2i and Creatinine clearance at day 0, Δcreate (day 1-day 0) and ventilation time. There was also a significant correlation between discharge DO2i and daytime urine output, ventilation time, hospital stay and in-hospital mortality. Through a univariable study, we compared the classic parameters of perfusion monitoring during CPB in addition to the starting DO2i with the different postoperative results. It was noted that the starting DO2i figures below the threshold of 270ml / min / m² were significantly correlated with the duration of administration of catecholamines postoperatively, with prolonged ventilation, with the variation in serum creatinine postoperatively and with in-hospital mortality.
Conclusion: DO2 is a monitoring tool that has proven its advantages for monitoring under CPB.