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Intensive Care Medicine

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01-05-2003 | Original

Gastric hypercarbia and adverse outcome after cardiac surgery

Authors: Minoo N. Kavarana, Robert J. Frumento, Andrew L. Hirsch, Mehmet C. Oz, Daniel C. Lee, Elliott Bennett-Guerrero

Published in: Intensive Care Medicine | Issue 5/2003

Abstract

Objective

: It has been postulated that splanchnic ischemia, as manifested by gastric hypercarbia, helps to trigger excessive systemic inflammation, which has been linked to the development of adverse postoperative outcome. This study examined whether gastric PCO₂ values are associated with adverse outcome in cardiac surgical patients.

Design and setting

Prospective cohort study in a tertiary-care hospital.

Patients

43 patients undergoing elective cardiac surgery.

Interventions

Simultaneous measurements of gastric PCO₂ (using automated air tonometry) and arterial PCO₂ were obtained at the beginning and end of surgery. The difference (gap) between regional PCO₂ and arterial PCO₂ (corrected for temperature) was calculated. Adverse outcome was defined as in-hospital death or prolonged (>10 days) postoperative hospitalization.

Measurements and results

Fourteen patients fulfilled the predefined definition for adverse outcome. Postoperative ICU stay and postoperative hospital length of stay were significantly longer in these patients. At the end of surgery gastric minus arterial PCO₂ gap was significantly larger in patients with adverse outcome. Global hemodynamic and perfusion related variables were not associated with adverse outcome (cardiac index, mean arterial pressure, mixed venous oxygen saturation, arterial lactate, arterial base excess).

Conclusions

Gastric minus arterial PCO₂ gap after surgery is larger in patients with adverse postoperative outcome, which supports the theory that gastrointestinal reduced perfusion is relevant to the pathogenesis of postoperative morbidity

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Title: Gastric hypercarbia and adverse outcome after cardiac surgery
Authors: Minoo N. Kavarana
Robert J. Frumento
Andrew L. Hirsch
Mehmet C. Oz
Daniel C. Lee
Elliott Bennett-Guerrero
Publication date: 01-05-2003
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 5/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-003-1687-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Gastric hypercarbia and adverse outcome after cardiac surgery

Abstract

Objective

Design and setting

Patients

Interventions

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and setting

Patients

Interventions

Measurements and results

Conclusions

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