Post-operative myocardial dysfunction does not affect the physiological response to early mobilization after coronary artery bypass grafting

Background:  An acute increase in oxygen demand can be compensated for either by increased cardiac index (CI) or increased oxygen extraction, resulting in reduced mixed venous oxygen saturation (SvO2). We tested the hypothesis that post‐operative cardiac dysfunction may explain why oxygen extraction...

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Published in:Acta anaesthesiologica Scandinavica 2005-10, Vol.49 (9), p.1241-1247
Main Authors: Kirkeby-Garstad, I., Stenseth, R., Sellevold, O. F. M.
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Aortic Valve - surgery
Biological and medical sciences
Cardiomyopathies - etiology
Cardiomyopathies - physiopathology
Chlorides - blood
Coronary Artery Bypass - adverse effects
Early Ambulation
early mobilization
Electrocardiography
Female
Heart Function Tests
Heart Valve Prosthesis Implantation
Hemodynamics - physiology
Humans
Lactic Acid - blood
Male
Medical sciences
Middle Aged
Oximetry
Oxygen - blood
Point-of-Care Systems
Post-operative myocardial dysfunction
Postoperative Complications - physiopathology
Posture - physiology
Stroke Volume - physiology
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Summary:Background:  An acute increase in oxygen demand can be compensated for either by increased cardiac index (CI) or increased oxygen extraction, resulting in reduced mixed venous oxygen saturation (SvO2). We tested the hypothesis that post‐operative cardiac dysfunction may explain why oxygen extraction alone is increased during early mobilization after cardiac surgery. Methods:  Twenty patients with a pre‐operative ejection fraction > 50% were included in an open prospective observational study comparing the changes in SvO2 and hemodynamics during mobilizations immediately prior to surgery and on the first post‐operative morning. Results:  Mobilization induced an absolute reduction in SvO2 of 17.7 ± 7.4% pre‐ and 19.0 ± 5.5% post‐operatively (NS). ANOVA for a series of measurements throughout the mobilization sequence identified no different effect on SvO2 between pre‐ and post‐operative mobilizations (P = 0.567). The SvO2 level was reduced post‐operatively resulting in a SvO2 during standing exercise of 55% before and 49% after the surgery (P 
ISSN:0001-5172
1399-6576
DOI:10.1111/j.1399-6576.2005.00854.x