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Predictive role of regional thigh tissue oxygen saturation monitoring during cardiopulmonary bypass in lung injury after cardiac surgery

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  • Cardiopulmonary Bypass
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Abstract

Acute respiratory distress syndrome (ARDS) is a serious complication following cardiac surgery mainly associated with the use of cardiopulmonary bypass (CPB), which could increase the risk of mortality and morbidity. This study investigated the association of regional oxygen saturation (rSO2) during CPB with postoperative outcomes, including respiratory function. Patients who underwent cardiac surgery with CPB from 2015 to 2019 were included. Near-infrared spectroscopy was used to monitor rSO2 at the forehead, abdomen, and thighs throughout the surgery. Postoperative markers associated with CPB were assessed for correlations with PaO2/FiO2 (P/F) ratios at intensive care unit (ICU) admission. Postoperative lung injury (LI) was defined as moderate or severe ARDS based on the Berlin criteria, and its incidence was 29.9% (20/67). On multiple regression analysis, the following were associated with P/F ratios at ICU admission: vasoactive-inotropic scores at CPB induction (P = 0.03), thigh rSO2 values during CPB (P = 0.04), and body surface area (P < 0.001). A thigh rSO2 of 71% during CPB was significantly predictive of postoperative LI with an area under the curve of 0.71 (P = 0.03), sensitivity of 0.70, and specificity of 0.68. Patients with postoperative LI had longer ventilation time and ICU stays. Thigh rSO2 values during CPB were a potential predictor of postoperative pulmonary outcomes.

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All data in this research are available upon reasonable request to the corresponding author.

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Acknowledgements

We greatly appreciated Ms. Rumina Nakamura, Medical Engineering student at Kitasato University for her drawing a figure of our CPB and monitoring system. We also greatly appreciated Dr. Masaki Iizuka, a qualified professional statistician, for his work in conducting the statistical analysis.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan

    Tomoki Tamura, Fumiaki Shikata, Tadashi Kitamura, Masaomi Fukuzumi, Yuki Tanaka & Kagami Miyaji

  2. Department of Medical Engineering, Kitasato University School of Allied Health Sciences, Sagamihara, Kanagawa, Japan

    Tomoyo Ebine, Kiyotaka Fujii & Satoshi Kohira

Authors
  1. Tomoki Tamura
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  2. Fumiaki Shikata
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  3. Tadashi Kitamura
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  4. Masaomi Fukuzumi
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  6. Tomoyo Ebine
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  7. Kiyotaka Fujii
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  8. Satoshi Kohira
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  9. Kagami Miyaji
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Contributions

Tomoki Tamura: Writing—original draft; Project administration; data collection. Fumiaki Shikata: Conceptualization, Writing—original draft, and formal analysis. Tadashi Kitamura: Conceptualization, supervision, review, and editing. Masaomi Fukuzumi: Data collection, review, and editing. Yuki Tanaka: Visualization and Data curation. Satoshi Kohira: Validation, visualization, data curation, and formal analysis. Kagami Miyaji: Supervision, review, and editing.

Corresponding authors

Correspondence to Tomoki Tamura or Fumiaki Shikata.

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Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Ethical approval

This retrospective study was approved by the Institutional Review Board (IRB) of Kitasato University Hospital on October 23, 2019 (approval no. B19-112).

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Informed consent was obtained using an opt-out approach on the websites approved by the IRB.

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Tamura, T., Shikata, F., Kitamura, T. et al. Predictive role of regional thigh tissue oxygen saturation monitoring during cardiopulmonary bypass in lung injury after cardiac surgery. J Artif Organs (2024). https://doi.org/10.1007/s10047-024-01438-y

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