Feasibility of continuous non-invasive delivery of oxygen monitoring in cardiac surgical patients: a proof-of-concept preliminary study.

Purpose: Oxygen delivery (DO ₂ ) and its monitoring are highlighted to aid postoperative goal directed therapy (GDT) to improve perioperative outcomes such as acute kidney injury (AKI) after high-risk cardiac surgeries associated with multiple morbidities and mortality. However, DO ₂ monitoring is neither routine nor done postoperatively, and current methods are invasive and only produce intermittent DO ₂ trends. Hence, we proposed a novel algorithm that simultaneously integrates cardiac output (CO), hemoglobin (Hb) and oxygen saturation (SpO ₂ ) from the Edwards Life Sciences ClearSight System® and Masimo SET Pulse CO-Oximetry® to produce a continuous, real-time DO ₂ trend.
Methods: Our algorithm was built systematically with 4 components - machine interface to draw data with PuTTY, data extraction with parsing, data synchronization, and real-time DO ₂ presentation using a graphic-user interface. Hb readings were validated.
Results: Our algorithm was implemented successfully in 93% (n = 57 out of 61) of our recruited cardiac surgical patients. DO ₂ trends and AKI were studied.
Conclusion: We demonstrated a novel proof-of-concept and feasibility of continuous, real-time, non-invasive DO ₂ monitoring, with each patient serving as their own control. Our study also lays the foundation for future investigations aimed at identifying personalized critical DO ₂ thresholds and optimizing DO ₂ as an integral part of GDT to enhance outcomes in perioperative cardiac surgery.
(© 2024. The Author(s).)