Affiliations: Department of General, Visceral and Vascular Surgery, Hospital Worms, Worms, Germany | Department of General, Visceral, Vascular and Paediatric Surgery, University Hospital of the Saarland, Homburg/Saar, Germany | Institute of Clinical Hemostaseology and Transfusion Medicine, University Hospital of the Saarland, Homburg/Saar, Germany | Department of Medical Statistics, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
Note: [] Corresponding author: Dr. M. Weinrich, Department of General, Visceral and Vascular Surgery, Hospital Worms, Gabriel-von-Seidl-Straße 81, D-67550 Worms, Germany. Tel.: +49 6241 501 3102; Fax: +49 6241 501 3199; E-mail: malte.weinrich@gmx.de.
Abstract: Introduction: Measurement of central venous oxygen saturation has become a surrogate parameter for fluid administration, blood transfusions and treatment with catecholamines in (early) goal directed therapy in the treatment of acute septic patients. These strategies are not easily transferred to the postoperative management of abdominal surgery due to the different conditions in surgical patients. Materials and methods: A study population of 15 patients (8 females/7 males) underwent elective major abdominal surgery: 6 gastrectomies, 5 major liver resections and 4 lower anterior rectum resections. Surgery was performed for primary or secondary malignancy. The patients' age was 65.4±12.7 (mean±standard deviation, range 44–84, median 62) years. Blood samples were taken intraoperatively from indwelling central venous lines as well as from draining veins at the surgical site. Blood gas analyses to determine the oxygen saturations were performed immediately. All patients were operated in standardized general anesthesia including epidural analgesia and in a balanced volume status. Results: Central venous oxygen saturations and oxygen saturations in blood from the draining veins of the surgical site showed a wide range with high intra- and interindividual differences intraoperatively. Overall, at most time points no correlation between the two oxygen saturations could be detected in three operation types. A significant correlation was only observed at one time point during liver resections. Conclusion: Our results show a lack of correlation between central venous oxygen saturations and oxygen saturations in the draining veins of the surgical site during major abdominal surgery. Measurement of central venous oxygen saturations does not seem to be a good surrogate for the local oxygen supply in the field of interest in major abdominal surgery even under standardized conditions.
Keywords: Central venous oxygen saturation, venous oxygen saturation at the surgical site, local venous oxygen saturation, major abdominal surgery
