Time course of changes in jugular venous oxygen saturation during hypothermic or normothermic cardiopulmonary bypass in patients with diabetes mellitus

• Published in: Acta anaesthesiologica Scandinavica Vol. 45; no. 7; pp. 858 - 862
• Main Authors: Kadoi, Y., Saito, S., Goto, F., Someya, T., Kamiyashiki, S., Fujita, N.
• Format: Journal Article
• Language: English
• Published: Copenhagen Munksgaard International Publishers 01.08.2001; Blackwell
• Subjects: Aged; Anesthesia; Anesthesia depending on type of surgery; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Gas Analysis; Cardioplegic Solutions; Cardiopulmonary Bypass; Diabetes Complications; diabetes mellitus; Diabetes Mellitus - blood; Diabetes Mellitus - physiopathology; Female; Hematocrit; Hemodynamics - drug effects; Humans; hypothermia; Hypothermia, Induced; internal jugular venous saturation; Jugular Veins - physiology; Male; Medical sciences; Middle Aged; Monitoring, Intraoperative; Neurological complication; Oxygen - blood; Risk Assessment; Thoracic and cardiovascular surgery. Cardiopulmonary bypass; Endocrinopathy; Human; Jugular vein; Nervous system diseases; Normothermia; Oxygen; Venous blood; Diabetes mellitus; Cardiovascular disease; General anesthesia; Induced hypothermia; Coronary heart disease; Cerebral disorder; Cardiopulmonary bypass; Aortocoronary; Bypass; Gas saturation; Central nervous system disease; Complication
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1034/j.1399-6576.2001.045007858.x

Background: Preexisting diabetic mellitus is a risk factor determining postoperative neurological disorders. The present study assesses the effects of normothermic and hypothermic cardiopulmonary bypass (CPB) on jugular venous oxygen saturation (SjvO2)in patients with preexisting diabetic mellitus. Methods: Sixteen diabetic patients who underwent elective coronary artery bypass grafting surgery were randomly divided into two groups: Group DN (n=8, diabetic patients) underwent normothermic CPB (>35°C), and group DH (n=8, diabetic patients) underwent hypothermic CPB (32°C). Controls were 16 age‐matched non‐diabetic patients (normothemic group, CN: n=8; hypothemic group, CH: n=8). A 4.0 F fiberoptic oximetry oxygen saturation catheter was inserted into the right jugular bulb to continuously monitor SjvO2 values. Hemodynamic parameters and arterial and jugular venous blood gases were measured seven times. Results: Cerebral desaturation, which was defined as SjvO2 values below 50%, was observed during normothermic CPB in diabetic patients (at the onset of CPB: 46±3%, at 20 min after onset of CPB: 49±3%, means±SD, respectively). No cerebral desaturation occurred in diabetic and control patients during hypothermic CPB. Conclusions: Patients with preexisting diabetes mellitus experienced cerebral desaturation during normothermic CPB.