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Erschienen in:
17.10.2017 | Original articles
Predictive value of ScvO2 monitoring for pericardial tamponade after cardiac surgery
Erschienen in: Herz | Ausgabe 1/2019
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Background
We examined the predictive value of central venous oxygen saturation (ScvO2) changes regarding the occurrence of pericardial tamponade following cardiac surgery.
Methods
We retrospectively identified 66 consecutive patients in whom ScvO2 and arterial lactate levels were analyzed during an 8‑h time interval preceding pericardiotomy due to pericardial tamponade (PT), and at equivalent time points in 30 control patients (C) who had an uncomplicated course.
Results
The median age of the patients was 74 years (interquartile range, 63–78). Three percent of procedures were re-operations. There were no differences between the baseline values of PT and C patients. Pericardiotomy was performed on average 1 day (0–3.5) after cardiac surgery. PT patients displayed a significant decline (p < 0.001) to lower ScvO2 levels (p < 0.001) and a significant increase (p = 0.005) to higher arterial lactate levels (p = 0.019) during the 8 h preceding pericardiotomy, whereas C patients did not (p = 0.440 and p = 0.279, respectively). PT was associated with a longer hospital stay (p = 0.04) and a higher in-hospital mortality (p = 0.008). An ScvO2 decline below 60% (p = 0.018), a delta ScvO2 decline greater than 5% (p = 0.001), and a delta lactate increase greater than 0.18 mmol/l (p = 0.002) during the 8 h preceding pericardiotomy were independently associated with PT. None of these parameters predicted in-hospital mortality.
Conclusion
Deteriorations in ScvO2 might serve as an early marker of PT following cardiac surgery.