Association between tissue oxygenation and myocardial injury in patients undergoing major spine surgery: A prospective cohort study

Katrine Feldballe Bernholm*, Christian S. Meyhoff, Philip Bickler

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

1 Citationer (Scopus)
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Abstract

Objective To describe the association between intraoperative tissue oxygenation and postoperative troponin elevation in patients undergoing major spine surgery. We hypothesised that a decrease in intraoperative skeletal muscle tissue oxygenation (SmO2) was associated with the peak postoperative cardiac troponin value. Design This is a prospective cohort study. Setting Single-centre, University of California San Francisco Medical Center. Participants Seventy adult patients undergoing major elective spine surgery. Primary and secondary outcome measures High-sensitivity troponin T (hsTnT) was measured in plasma preoperatively and on the first and second day after surgery to assess the primary outcome of peak postoperative hsTnT. Secondary outcomes included MINS and intensive care unit (ICU) admission within 30 days. Skeletal cerebral tissue oxygenation and SmO2 was measured continuously with near-infrared spectroscopy during surgery. The primary exposure variable was time-weighted area under the curve (TW AUC) for SmO2. Results Mean age was 65 (33-85) years and 59% were female. No significant association was found between TW AUC for SmO2 and peak hsTnT (Spearman's correlation, rs =0.17, p=0.16). A total of 28 (40%) patients had MINS. ICU admission occurred in 14 (40%) in lower vs 25 (71%) in upper half of patients based on TW AUC for SmO2, p=0.008. Conclusions Decrease in SmO2 was not a statistically significant predictor for peak troponin value following major spine surgery but is a potential predictor for other postoperative complications.

OriginalsprogEngelsk
Artikelnummere044342
TidsskriftBMJ Open
Vol/bind11
Udgave nummer9
ISSN2044-6055
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
funding from Boehringer Ingelheim, Ferring Pharmaceuticals, Radiometer and Merch, Sharp & Dohme, as well as lecture fees from Radiometer, all outside submitted work. The remaining authors declare that they have no conflict of interest.

Funding Information:
Funding This work was supported by a grant from the Lundbeck Foundation Clinical Research Fellowship 2017–2018 for Katrine Feldballe Bernholm. Grant number not applicable. CAS Medical Systems provided the FORE-SIGHT ELITE Tissue Oximeter and probes at no cost.

Publisher Copyright:
© Author(s) (or their employer(s)) 2021.

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