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Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske, Vol. 72 No. 1, 2018.

Professional paper

CLINICAL COMPARISON OF INVOS OXYMETRY AND ARTERIAL LACTATE LEVELS AS A PREDICTOR OF PERIPHERAL PERFUSION AND REPERFUSION IN VASCULAR SURGERY PATIENTS

TINA TOMIĆ MAHEČIĆ orcid id orcid.org/0000-0003-2470-6238 ; Zagreb University Hospital Centre, Department of Anesthesiology and Intensive Care, Zagreb, Croatia
DORA KARMELIĆ ; Zagreb University Hospital Centre, Department of Anesthesiology and Intensive Care, Zagreb, Croatia
KATARINA LOJNA ; Zagreb University Hospital Centre, Department of Anesthesiology and Intensive Care, Zagreb, Croatia
IVA TUCIĆ ; Zagreb University Hospital Centre, Department of Anesthesiology and Intensive Care, Zagreb, Croatia

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Abstract

The aim of this pilot project was to evaluate the use of INVOS oxymetry to optimize anesthesia in lower extremities in patients with peripheral arterial disease (PAD). Four patients with critical ischemia of lower extremities were evaluated. With the electrode indicating cerebral perfusion (crSO2), another INVOS electrode was placed distally from the vascular clamp (prSO2). The data obtained were used as predictors of peripheral perfusion and necessity of intervention. We compared the
aforementioned data with the arterial blood lactate levels. The initial mean crSO2 and prSO2 value was 62.25% and 53.5%, respectively. The mean duration of arterial occlusion was 61 minutes. The patients received a mean of 1275 mL crystalloids and 500 mL colloids. The highest measured lactate value was 0.7 mmol/L. Postoperative crSO2 averaged 73% and prSO2 69.75%. The mean length of hospital stay was 19.25 days, with a 30-day survival rate of 100%, without the need of reoperation or amputation. Reviewing the scientific literature available, we found no similar clinical experiences of optical spectrometry used as a method of measuring intraoperative perfusion of the ischemic extremity. Utilizing INVOS data to improve perfusion of periphery, we used minimal vasoactive support and restrictive bolus administration of intravenous fl uids with a satisfactory clinical outcome.

Keywords

peripheral arterial disease; INVOS; monitoring; lactate levels

Hrčak ID:

197722

URI

https://hrcak.srce.hr/197722

Publication date:

3.4.2018.

Article data in other languages: croatian

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