Minimally Invasive Determinations of Oxygen Delivery and Consumption in Cardiac Surgery: An Observational Study

David T M Burtman, Annick Stolze, Selma E Kaffka Genaamd Dengler, Alexander B A Vonk, Christa Boer

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVE: Evaluate minimally invasive assessment of oxygen delivery (DO2) and oxygen consumption (VO2) and determine its level of agreement with the gold standard approach of those measurements in patients undergoing cardiac surgery.

DESIGN: Observational study.

SETTING: Single center, VU University Medical Center (Amsterdam, The Netherlands).

PARTICIPANTS: The study comprised 29 adult patients.

INTERVENTION: Parallel measurements of invasive and minimally invasive parameters required for the calculation of DO2 and VO2.

MEASUREMENTS AND MAIN RESULTS: Measurements were performed after anesthesia induction (T1) and before sternal closure (T2) in adult cardiac surgery. The invasive approach included arterial and pulmonary artery catheter-derived blood sampling and cardiac output measurements. The minimally invasive approach included pulse oximetry, point-of-care hemoglobin, Nexfin-based cardiac output, and central venous catheter-derived blood sampling. Level of agreement was determined using Bland-Altman analysis and percentage error. DO2 and VO2 levels were determined in patients 71 ± 8 years old. DO2 measurements showed a level of agreement of -17 ± 57 L/min/m2 and -18 ± 72 L/min/m2 with percentage errors of 35% and 38% at T1 and T2, respectively. VO2 assessment showed a level of agreement of -5 ± 18 L/min/m2 and -12 ± 22 L/min/m2, with percentage errors of 47% at T1 and T2. The highest percentage errors were for cardiac output measurements, 33% and 28% at T1 and T2, respectively.

CONCLUSION: Agreement between minimally invasive and invasive DO2 and VO2 determinations is, moderate and poor, respectively. These findings may be explained by the poor agreement between minimally invasive and invasive cardiac output measurements.

Original languageEnglish
Pages (from-to)1266-1272
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume32
Issue number3
DOIs
Publication statusPublished - Jun 2018

Cite this

@article{5d88672f748c467cacc03b192bacf026,
title = "Minimally Invasive Determinations of Oxygen Delivery and Consumption in Cardiac Surgery: An Observational Study",
abstract = "OBJECTIVE: Evaluate minimally invasive assessment of oxygen delivery (DO2) and oxygen consumption (VO2) and determine its level of agreement with the gold standard approach of those measurements in patients undergoing cardiac surgery.DESIGN: Observational study.SETTING: Single center, VU University Medical Center (Amsterdam, The Netherlands).PARTICIPANTS: The study comprised 29 adult patients.INTERVENTION: Parallel measurements of invasive and minimally invasive parameters required for the calculation of DO2 and VO2.MEASUREMENTS AND MAIN RESULTS: Measurements were performed after anesthesia induction (T1) and before sternal closure (T2) in adult cardiac surgery. The invasive approach included arterial and pulmonary artery catheter-derived blood sampling and cardiac output measurements. The minimally invasive approach included pulse oximetry, point-of-care hemoglobin, Nexfin-based cardiac output, and central venous catheter-derived blood sampling. Level of agreement was determined using Bland-Altman analysis and percentage error. DO2 and VO2 levels were determined in patients 71 ± 8 years old. DO2 measurements showed a level of agreement of -17 ± 57 L/min/m2 and -18 ± 72 L/min/m2 with percentage errors of 35{\%} and 38{\%} at T1 and T2, respectively. VO2 assessment showed a level of agreement of -5 ± 18 L/min/m2 and -12 ± 22 L/min/m2, with percentage errors of 47{\%} at T1 and T2. The highest percentage errors were for cardiac output measurements, 33{\%} and 28{\%} at T1 and T2, respectively.CONCLUSION: Agreement between minimally invasive and invasive DO2 and VO2 determinations is, moderate and poor, respectively. These findings may be explained by the poor agreement between minimally invasive and invasive cardiac output measurements.",
author = "Burtman, {David T M} and Annick Stolze and {Genaamd Dengler}, {Selma E Kaffka} and Vonk, {Alexander B A} and Christa Boer",
note = "Copyright {\circledC} 2017 The Authors. Published by Elsevier Inc. All rights reserved.",
year = "2018",
month = "6",
doi = "10.1053/j.jvca.2017.06.042",
language = "English",
volume = "32",
pages = "1266--1272",
journal = "Journal of Cardiothoracic and Vascular Anesthesia",
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Minimally Invasive Determinations of Oxygen Delivery and Consumption in Cardiac Surgery : An Observational Study. / Burtman, David T M; Stolze, Annick; Genaamd Dengler, Selma E Kaffka; Vonk, Alexander B A; Boer, Christa.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 32, No. 3, 06.2018, p. 1266-1272.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Minimally Invasive Determinations of Oxygen Delivery and Consumption in Cardiac Surgery

T2 - An Observational Study

AU - Burtman, David T M

AU - Stolze, Annick

AU - Genaamd Dengler, Selma E Kaffka

AU - Vonk, Alexander B A

AU - Boer, Christa

N1 - Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

PY - 2018/6

Y1 - 2018/6

N2 - OBJECTIVE: Evaluate minimally invasive assessment of oxygen delivery (DO2) and oxygen consumption (VO2) and determine its level of agreement with the gold standard approach of those measurements in patients undergoing cardiac surgery.DESIGN: Observational study.SETTING: Single center, VU University Medical Center (Amsterdam, The Netherlands).PARTICIPANTS: The study comprised 29 adult patients.INTERVENTION: Parallel measurements of invasive and minimally invasive parameters required for the calculation of DO2 and VO2.MEASUREMENTS AND MAIN RESULTS: Measurements were performed after anesthesia induction (T1) and before sternal closure (T2) in adult cardiac surgery. The invasive approach included arterial and pulmonary artery catheter-derived blood sampling and cardiac output measurements. The minimally invasive approach included pulse oximetry, point-of-care hemoglobin, Nexfin-based cardiac output, and central venous catheter-derived blood sampling. Level of agreement was determined using Bland-Altman analysis and percentage error. DO2 and VO2 levels were determined in patients 71 ± 8 years old. DO2 measurements showed a level of agreement of -17 ± 57 L/min/m2 and -18 ± 72 L/min/m2 with percentage errors of 35% and 38% at T1 and T2, respectively. VO2 assessment showed a level of agreement of -5 ± 18 L/min/m2 and -12 ± 22 L/min/m2, with percentage errors of 47% at T1 and T2. The highest percentage errors were for cardiac output measurements, 33% and 28% at T1 and T2, respectively.CONCLUSION: Agreement between minimally invasive and invasive DO2 and VO2 determinations is, moderate and poor, respectively. These findings may be explained by the poor agreement between minimally invasive and invasive cardiac output measurements.

AB - OBJECTIVE: Evaluate minimally invasive assessment of oxygen delivery (DO2) and oxygen consumption (VO2) and determine its level of agreement with the gold standard approach of those measurements in patients undergoing cardiac surgery.DESIGN: Observational study.SETTING: Single center, VU University Medical Center (Amsterdam, The Netherlands).PARTICIPANTS: The study comprised 29 adult patients.INTERVENTION: Parallel measurements of invasive and minimally invasive parameters required for the calculation of DO2 and VO2.MEASUREMENTS AND MAIN RESULTS: Measurements were performed after anesthesia induction (T1) and before sternal closure (T2) in adult cardiac surgery. The invasive approach included arterial and pulmonary artery catheter-derived blood sampling and cardiac output measurements. The minimally invasive approach included pulse oximetry, point-of-care hemoglobin, Nexfin-based cardiac output, and central venous catheter-derived blood sampling. Level of agreement was determined using Bland-Altman analysis and percentage error. DO2 and VO2 levels were determined in patients 71 ± 8 years old. DO2 measurements showed a level of agreement of -17 ± 57 L/min/m2 and -18 ± 72 L/min/m2 with percentage errors of 35% and 38% at T1 and T2, respectively. VO2 assessment showed a level of agreement of -5 ± 18 L/min/m2 and -12 ± 22 L/min/m2, with percentage errors of 47% at T1 and T2. The highest percentage errors were for cardiac output measurements, 33% and 28% at T1 and T2, respectively.CONCLUSION: Agreement between minimally invasive and invasive DO2 and VO2 determinations is, moderate and poor, respectively. These findings may be explained by the poor agreement between minimally invasive and invasive cardiac output measurements.

U2 - 10.1053/j.jvca.2017.06.042

DO - 10.1053/j.jvca.2017.06.042

M3 - Article

VL - 32

SP - 1266

EP - 1272

JO - Journal of Cardiothoracic and Vascular Anesthesia

JF - Journal of Cardiothoracic and Vascular Anesthesia

SN - 1053-0770

IS - 3

ER -