Korelacija između saturacije kiseonikom centralne i mešane venske krvi u elektivnoj hirurgiji aneurizme abdominalne aorte

  • Ljiljana Šoškić Klinika za kardiohirurgiju, Centar za anesteziju, Klinicki centar Srbije
  • Mladen Kočica Klinika za kardiohirurgiju, Klinicki centar Srbije
  • Dragan Cvetković Klinika za kardiohirurgiju,Klinicki centar Srbije
  • Biljana Miličić University of Belgrade, Faculty of Dentistry, Department of Medical Statistics and Informatics
  • Nebojsa Ladjevic Clinical Center of Serbia, Clinic for Urology, ‡Department of Anesthesia and Intensive Care, Clinic for Abdominal Surgery
  • Ivan Palibrk Centar za anestezijologiju i reanimatologiju Klinickog centra Srbije
  • Milica Karadžić Klinika za kardiohirurgiju, Centar za anesteziju, Klinicki centar Srbije
  • Miloš Grujić Klinika za kardiohirurgiju, Klinicki centar Srbije
  • Milica Vještica-Mrdak Klinika za vaskularnu hirurgiju, Centar za anesteziju, Klinicki centar Srbije
  • Arsen Ristić Klinika za kardiologiju, Klinicki centar Srbije
DOI: https://doi.org/10.2298/VSP180621131S
Ključne reči: aorta, abdominalna;, aorta, aneurizma;, fiziološke funkcije, praćenje;, kiseonik;, oksimetrija

Sažetak


Uvod/Cilj. Koncept korišćenja saturacije kiseonikom cen­tralne venske krvi (ScvO2), umesto saturacije mešane venske krvi (SvO2), za izračunavanje srčanog indeksa (CI), ostaje kontroverzan s obzirom na to da još uvek nema pouzdanih podataka koji bi ukazivali da jedna saturacija može biti ade­kvatna zamena drugoj. Odnos između ova dva parametra testirali smo upoređivanjem vrednosti CI izračunatih na dva načina, kod elektivno operisanih bolesnika zbog aneurizme abdominalne aorte (AAA). Cilj rada bio je testiranje korela­cije između ScvO2 i SvO2 u različitim vremenima merenja kod bolesnika podvrgnutih elektivnim operacijama AAA, kao i utvrđivanje mogućnosti korišćenja ScvO2 za izračuna­vanje CI, modifikovanom Fick-ovom jednačinom, kao ade­kvatne zamene vrednostima CI dobijenih merenjem putem plućnog arterijskog katetera (PAC). Metode. Prospektiv­nom opservacionom studijom bilo je obuhvaćeno 125 kon­sekutivnih bolesnika podvrgnutih elektivnim operacijama AAA. Podaci o ScvO2 i SvO2, kao i vrednosti CI dobijeni su uzimanjem uzoraka krvi i merenjem u tri različita vremena: posle uvoda u opštu anesteziju (T0), odmah posle prijema u jedinicu intenzivnog lečenja (JIL) (T1), i osam sati posle dolaska u JIL (T2). Za izračunavanje CI upotrebljena je po­jednostavljena Fick-ova jednačina po Walley-u, u kojoj smo koristili ScvO2 (CI-F). Rezultati. Nađena je dobra linearna korelacija između vrednosti ScvO2 i SvO2 u svim vreme­nima merenja, a linearna regresiona studija pokazala je naj­jači koeficijent determinacije (R2 = 0.661) u T2 vremen­skom okviru. Nije bilo korelacije između CI-F (CI izračunat iz ScvO2 modifikovanom Fick-ovom jednačinom) i CI (me­ren PAC-om) u bilo kom vremenskom okviru. Zaključak. Rezultati studije potvrđuju da ScvO2 može biti pouzdana zamena za SvO2 kod bolesnika podvrgnutih elektivnim ope­racijama AAA. Međutim, ScvO2 se ne može koristiti kao su­rogat za pravu SvO2 u izračunavanju CI.

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Objavljeno
2021/04/12
Broj časopisa
Vol. 77 Br. 7 (2020): Vojnosanit Pregl
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Originalni članak