[en] Automated online tonometry displays a rapid, semicontinuous measurement of gastric-to-end tidal carbon dioxide (Pr-etCO(2)) as an index of gastrointestinal perfusion during surgery. Its use to predict postoperative outcome has not been studied in general surgery patients. We, therefore, studied ASA physical status III-IV patients operated on for elective surgery under general anesthesia and a planned duration of >2 h in a European, multicenter study. As each center was equipped with only 1 tonometric monitor, a randomization was performed if more than one patient was eligible the same day. Patients not monitored with tonometry were assessed only for follow-up. The main outcome measure was the assessment of postoperative functional recovery delay (FRD) on day 8. Among the 290 patients studied, 34% had FRD associated with a longer hospital stay. The most common FRDs were gastrointestinal (45%), infection (39%), and respiratory (35%). In those monitored with tonometry (n = 179), maximum Pr-etCO(2) proved to be the best predictor increasing the probability of FRD from 34% for all patients to 65% at a cut-off of 21 mm Hg (2.8 kPa) (sensitivity 0.27, specificity 0.92, positive predictive value 64%, negative predictive value 70%). We conclude that intraoperative Pr-etCO(2) measurement may be a useful prognostic index of postoperative morbidity.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Lebuffe, Gilles
Vallet, Benoît
Takala, Jukka
Hartstein, Gary ; Centre Hospitalier Universitaire de Liège - CHU > Urgences
Lamy, Maurice ; Université de Liège - ULiège > Département des sciences cliniques > Anesthésie et réanimation
Bakker, Jan; University Hospital Apeldoorn, Netherlands > Department of Intensive Care
Bennett, David
Boyd, Owen
Webb, Andrew
Language :
English
Title :
A European, multicenter, observational study to assess the value of gastric-to-end tidal Pco(2) difference in predicting postoperative complications
Publication date :
July 2004
Journal title :
Anesthesia and Analgesia
ISSN :
0003-2999
eISSN :
1526-7598
Publisher :
Lippincott Williams & Wilkins, Philadelphia, United States - Pennsylvania
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