Relation between systemic oxygen uptake and tissue oxygen extraction following cardiac surgery

Twenty-three patients undergoing elective coronary artery bypass graft surgery with moderate hypothermic bypass, under opiate-benzodiazepine anaesthesia were investigated during the first 7 h following surgery. Patients with recent myocardial infarct (<6 weeks), reduced left ventricular ejection fraction (<40%) or requiring inotropic support were excluded. During the first 3 h after surgery, higher oxygen uptake and oxygen extraction ratio were found in shivering patients (n=5) compared with non-shivering patients (n=16). A significant relation was found between oxygen uptake and the oxygen extraction ratio for the pooled data (R=0.80 and 0.87, in shivering and non-shivering patients, respectively) as well as for the individual patients. A weaker relation was observed between cardiac output and oxygen uptake. The lack of adequate circulatory compensation could be related to the depressant effects of residual anaesthesia on the myocardium, surgical trauma, cardioplegic arrest and to peripheral vasoconstriction.