Medición de saturación de oxígeno en mucosa colónica durante cirugía aortica

Intraoperative Colon Mucosal Oxygen Saturation During Aortic Surgery
Presented at the 1st Annual Academic Surgical Congress held February 7–11, 2006, San Diego, CA.
Eugene S. Lee M.D., Ph.D., , , Arie Bass M.D.†, Frank R. Arko M.D.‡, Maarit Heikkinen M.D.§, E. John Harris M.D.§, Christopher K. Zarins M.D.§, Pieter van der Starre M.D.¶ and Cornelius Olcott M.D.§ †Department of Surgery, Saklar School of Medicine, Tel Aviv, Israel‡Department of Surgery, UT Southwestern Medical Center at Dallas, Dallas, TexasDepartment of Surgery, University of California, Davis, California§Department of Surgery, Stanford University, Stanford, California¶Department of Anesthesiology, Stanford University, Stanford, California

Background
Colonic ischemia after aortic reconstruction is a devastating complication with high mortality rates. This study evaluates whether Colon Mucosal Oxygen Saturation (CMOS) correlates with colon ischemia during aortic surgery.
Materials and methods
Aortic reconstruction was performed in 25 patients, using a spectrophotometer probe that was inserted in each patient’s rectum before the surgical procedure. Continuous CMOS, buccal mucosal oxygen saturation, systemic mean arterial pressure, heart rate, pulse oximetry, and pivotal intra-operative events were collected.
Results
Endovascular aneurysm repair (EVAR) was performed in 20 and open repair in 5 patients with a mean age of 75 ± 10 (±SE) years. CMOS reliably decreased in EVAR from a baseline of 56% ± 8% to 26 ± 17% (P < p =" 0.81).

Conclusions
Intra-operative CMOS is a sensitive measure of colon ischemia where intraoperative events correlated well with changes in mucosal oxygen saturation. Transient changes demonstrate no problem. However, persistently low CMOS suggests colon ischemia, thus providing an opportunity to revascularize the inferior mesenteric artery or hypogastric arteries to prevent colon infarction.