Effect of Internal Mammary Artery Harvest on Incisional Transcutaneous Oxygen Following Coronary Artery Bypass Grafting

2.50
Hdl Handle:
http://hdl.handle.net/10755/158447
Type:
Presentation
Title:
Effect of Internal Mammary Artery Harvest on Incisional Transcutaneous Oxygen Following Coronary Artery Bypass Grafting
Abstract:
Effect of Internal Mammary Artery Harvest on Incisional Transcutaneous Oxygen Following Coronary Artery Bypass Grafting
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2004
Author:Tescher, Ann, PhD, RN, CCRN, CCNS
Contact Address:, 1216 2nd Street SW, Rochester, MN, 55902, USA
Internal mammary artery (IMA) harvest in coronary artery bypass graft (CABG) surgery is a known risk factor for sternal wound infection, yet nurses are limited in their ability to non-invasively assess tissue perfusion/oxygenation in the early postoperative period. This study was done to determine the effect of IMA harvest on the incisional transcutaneous oxygen (TcPO2) following CABG surgery. Conceptual Framework: The concepts of wound healing, the role of oxygen in healing, and non-invasive assessment of tissue oxygenation guided this study. Subjects: 21 adults undergoing elective CABG with single vessel IMA harvest. Methods: TcPO2 was measured and a Regional Perfusion Index (TcPO2 RPI) calculated on both sides of the sternal incision at the second and fifth intercostal spaces and a shoulder reference point. TcPO2 levels and other physiologic measures influencing tissue oxygenation (heart rate/rhythm, blood pressure, hemoglobin oxygen saturation) were measured at three distinct times which corresponded to normal metabolism, the inflammatory, and early proliferative phases of healing. Results: Data were analyzed by repeated measures two-way ANOVA. A significant difference in TcPO2 RPI was found on the harvested side of the sternum at the fifth intercostal space, both in the degree of decrease and rate of recovery over time (p=.001). No difference related to IMA harvest was found at the level of the second intercostal space either in the degree of decrease or recovery of TcPO2 levels over time (p=.291). Five subjects who exhibited the greatest decrease in TcPO2 levels from baseline differed from the rest of the group with increased age and smoking history, lower pre-operative medication use, and higher intra-operative fluid balance. Conclusions: TcPO2 monitoring can be used to identify compromised tissue oxygenation even in the presence of adequate systemic oxygenation. Thus, it could be a useful tool in nursing assessment of acute wound healing.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEffect of Internal Mammary Artery Harvest on Incisional Transcutaneous Oxygen Following Coronary Artery Bypass Graftingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158447-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Effect of Internal Mammary Artery Harvest on Incisional Transcutaneous Oxygen Following Coronary Artery Bypass Grafting</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Tescher, Ann, PhD, RN, CCRN, CCNS </td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, 1216 2nd Street SW, Rochester, MN, 55902, USA</td></tr><tr><td colspan="2" class="item-abstract">Internal mammary artery (IMA) harvest in coronary artery bypass graft (CABG) surgery is a known risk factor for sternal wound infection, yet nurses are limited in their ability to non-invasively assess tissue perfusion/oxygenation in the early postoperative period. This study was done to determine the effect of IMA harvest on the incisional transcutaneous oxygen (TcPO2) following CABG surgery. Conceptual Framework: The concepts of wound healing, the role of oxygen in healing, and non-invasive assessment of tissue oxygenation guided this study. Subjects: 21 adults undergoing elective CABG with single vessel IMA harvest. Methods: TcPO2 was measured and a Regional Perfusion Index (TcPO2 RPI) calculated on both sides of the sternal incision at the second and fifth intercostal spaces and a shoulder reference point. TcPO2 levels and other physiologic measures influencing tissue oxygenation (heart rate/rhythm, blood pressure, hemoglobin oxygen saturation) were measured at three distinct times which corresponded to normal metabolism, the inflammatory, and early proliferative phases of healing. Results: Data were analyzed by repeated measures two-way ANOVA. A significant difference in TcPO2 RPI was found on the harvested side of the sternum at the fifth intercostal space, both in the degree of decrease and rate of recovery over time (p=.001). No difference related to IMA harvest was found at the level of the second intercostal space either in the degree of decrease or recovery of TcPO2 levels over time (p=.291). Five subjects who exhibited the greatest decrease in TcPO2 levels from baseline differed from the rest of the group with increased age and smoking history, lower pre-operative medication use, and higher intra-operative fluid balance. Conclusions: TcPO2 monitoring can be used to identify compromised tissue oxygenation even in the presence of adequate systemic oxygenation. Thus, it could be a useful tool in nursing assessment of acute wound healing. </td></tr></table>en_GB
dc.date.available2011-10-26T21:03:47Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:03:47Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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