Few Anesthesiologists Monitor Key Heart Signal
MONDAY June 13, 2011 -- During high-risk surgery, only about one-third of anesthesiologists measure oxygen flow throughout their patient's body, even though this heart function can significantly affect recovery, according to a new survey.
Researchers in Amsterdam surveyed 463 European and American anesthesiologists and found that 95 percent knew it was critically important that enough oxygen reach all parts of a patient's body during high-risk surgery, but only 35 percent were actually monitoring their patients' cardiac output.
"If cardiac output is not measured there is no way to know whether oxygen is delivered appropriately to the tissues or not," said the study's lead author, Dr. Maxime Cannesson, associate professor of anesthesiology at the University of California, Irvine, in a news release from the European Anaesthesiology Congress.
Roughly 30 million patients around the world undergo high-risk surgery every year, according to the news release.
The anesthesiologists surveyed said they didn't monitor cardiac output mainly because the procedure was too invasive or they used other methods for monitoring the heart's performance.
In response, the study's authors argued current cardiac output monitoring is less invasive than it used to be, and alternate means of monitoring cardiac output, such as pulse pressure variations, are an ineffective substitute.
The study, which was presented Sunday at the European Anaesthesiology Congress in Amsterdam, noted previous research has shown that when anesthesiologists measure and set goals for cardiac output during high-risk surgery, survival rates increase and the number of complications drop. Surgical patients can also go home sooner.
"The idea is very simple: Since oxygen is of major importance to the body when it is experiencing stress, as in the case of high-risk surgery, it seems logical that setting goals for maximizing the delivery of oxygen to the tissues would improve patients' care," said Cannesson. "If the cells and tissues do not receive oxygen during the surgery, they are going to produce toxins, which will eventually worsen the situation and increase postoperative complications such as infection, kidney failure, pneumonia, and so forth," he added.
Based on their findings, the study's authors called for the creation of national and international guidelines to ensure that cardiac output monitoring is carried out during and after all high-risk surgeries.
Research presented at medical meetings is considered preliminary until it is published in a peer-reviewed medical journal.
The American Society of Anesthesiologists provides more information on the role of anesthesiologists in the operating room.
Posted: June 2011