ABSTRACT
We have used continuous and concurrent monitoring of arterial oxygen saturation (SpO2) and ECG to study the relationship between hypoxaemia and silent myocardial ischaemia in the perioperative period in 11 patients with cardiovascular disease. Ischaemic and hypoxaemic events occurred in all patients. Many events were shortlived and occurred independently of each other. However, our results suggest a close correlation between the duration of hypoxaemia and myocardial ischaemia. Ischaemia is more likely to occur if an episode of hypoxaemia is prolonged (beyond 5 min; P less than 0.01, chi square) and severe (SpO2 less than 85%; P less than 0.05, chi square).
Subject(s)
Coronary Disease/etiology , Hypoxia/complications , Aged , Aged, 80 and over , Cardiovascular Diseases/complications , Electrocardiography , Female , Humans , Male , Middle Aged , Monitoring, Physiologic/methods , Oximetry/methods , Postoperative Period , Time FactorsABSTRACT
We have used continuous ambulatory electrocardiography in the perioperative period to monitor 108 patients with known cardiovascular disease undergoing non-cardiac surgery. There was a high incidence of ischaemic ST segment changes and ventricular arrhythmias. For the group as a whole, anaesthesia and surgery were followed by increased ventricular ectopic activity, but did not worsen myocardial ischaemia. However, the mean duration of ischaemic ST segment changes was increased significantly in those patients with treated hypertension. Of the risk factors considered, preoperative ischaemia and peroperative systolic arterial pressure were significant correlates with postoperative myocardial ischaemia.
