A comparison among portal lactate, intramucosal sigmoid Ph, and deltaCO2 (PaCO2 - regional Pco2) as indices of complications in patients undergoing abdominal aortic aneurysm surgery.

Anesthesia and Analgesia
Abele DonatiPaolo Pelaia

Abstract

Our aim in this observational, prospective, noncontrolled study was to detect, in 29 patients who underwent abdominal aortic aneurysm (AAA) surgery, correlations between the incidence of postoperative organ failure and intraoperative changes in arterial and portal blood lactate; changes in intramucosal sigmoid pH (pHi); differences between sigmoid Pco(2) and arterial Pco(2) (DeltaCO(2)); and hemoglobin (Hb). Hb, arterial blood lactate concentrations, pHi, and DeltaCO(2) (air tonometry) were recorded at the start of anesthesia (T0), before aorta clamping (T1), 30 minutes after clamping (T2), and at the end of surgery (T3). Portal venous lactate concentrations were recorded at T1 and T2. Patients were stratified into two groups: group A patients had no postoperative organ failure, and group B patients had one or more organ failures. As compared with group A (n = 16), group B patients (n = 13) had a lower pHi value at T2 and T3 and a higher DeltaCO(2) at T3. A pHi value of <7.15 was a predictor of organ failure, with a sensitivity of 92.3%, a specificity of 68.8%, and positive and negative predictive values of 70.6% and 91.7%, respectively, whereas a DeltaCO(2) value of >28 mm Hg predicted later organ failure with a sensitivity of...Continue Reading

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Citations

Mar 1, 2013·Annals of Intensive Care·Paul A van BeestPeter E Spronk
May 16, 2013·Critical Care : the Official Journal of the Critical Care Forum·Maurizio CecconiAndrew Rhodes
Apr 11, 2014·Surgical Endoscopy·Subramanian NachiappanOmar Faiz
Jun 18, 2005·Anaesthesia·M WeissP Hasenclever
Aug 17, 2014·BMC Surgery·James StudnickiSara Shahbazi
Jul 29, 2010·Current Opinion in Critical Care·Namkje A R VellingaE Christiaan Boerma
Apr 30, 2021·Scientific Reports·Christoph R BehemConstantin J C Trepte

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