RESUMEN
Venous pulsations are thought, but to our knowledge have never been demonstrated, to result in underestimation of oxygen saturation measured by pulse oximetry (SpO2); however, to our knowledge, this has never been demonstrated. A patient with ischemic cardiomyopathy requiring intra-aortic balloon counterpulsation (IABC) had to withstand a temporary cessation of IABC (period I), during which she had marked central venous pulsations and a pulse oximeter bias of -18%. After IABC was reinstituted (period II), the venous pulsations disappeared and the bias was reduced to 0%. Cardiac output, systemic vascular resistance, and temperature during both periods were comparable. Pulmonary vascular resistance, however, was much lower during period II. We postulate that the bias was caused by venous pulsations significantly contributing to the AC, or variable component, of light absorption.
Asunto(s)
Presión Venosa Central , Enfermedad Coronaria/fisiopatología , Contrapulsador Intraaórtico , Oximetría , Oxígeno/sangre , Pulso Arterial , Anciano , Dióxido de Carbono/sangre , Cateterismo Periférico , Cateterismo de Swan-Ganz , Enfermedad Coronaria/sangre , Contrapulsación , Arteria Femoral , Frecuencia Cardíaca , Humanos , Masculino , Monitoreo Intraoperatorio , Arteria Pulmonar/fisiopatología , Resistencia VascularRESUMEN
Experiments were conducted on 18 dogs using an in situ blood-perfused canine heart model. Intracoronary infusion of AMP resulted in increased ATP and total adenine nucleotide levels. On reperfusion following a 15-min period of ischemia, ATP and total adenine nucleotide levels were significantly higher than control. Most important, contractile function recovered more rapidly in the AMP-treated dogs. It is therefore concluded that the delayed functional recovery noted after periods of ischemia is likely to be a direct result of delayed ATP resynthesis.