Patient characteristics
. | Trigger < 8 g/dL (n = 29) . | Trigger < 9.7 g/dL (n = 29) . |
---|---|---|
Age, mean ± SD, y | 71.3 ± 9.4 | 73.7 ± 7.3 |
Male sex, n (%) | 19 (65.5) | 18 (62.1) |
BMI, mean ± SD, kg/m2 | 25.3 ± 5.8 | 24.8 ± 3.8 |
Operation, n (%) | ||
Lower limb bypass | 17 (58.6) | 16 (55.2) |
Abdominal aortic aneurysm* | 12 (41.4) | 13 (44.8) |
Time of randomization, n (%) | ||
The day before surgery | 2 (6.9) | 3 (10.3) |
During surgery | 20 (69.0) | 21 (72.4) |
After end of surgery | 7 (24.1) | 5 (17.2) |
Any cardiovascular disease, n (%) | 26 (89.7) | 23 (79.3) |
Lower extremity artery disease | 20 (69.0) | 17 (58.6) |
Claudication | 4 (13.8) | 1 (3.4) |
Pain at rest | 4 (13.8) | 5 (17.2) |
Wound/gangrene | 12 (41.4) | 11 (37.9) |
Angina | 3 (10.3) | 5 (17.2) |
Stroke or TIA | 8 (27.6) | 5 (17.2) |
Previous CABG or PCI | 3 (10.3) | 5 (17.2) |
Congestive heart failure | 1 (3.4) | 2 (6.9) |
Heart valve disease | 3 (10.3) | 4 (13.8) |
Acute myocardial infarction | 0 (0.0) | 6 (20.7) |
Pacemaker | 0 (0.0) | 0 (0.0) |
Any cardiovascular risk factor, n (%) | 29 (100.0) | 28 (96.6) |
Arterial hypertension | 19 (65.5) | 22 (75.9) |
Smoker | 12 (41.4) | 11 (37.9) |
COPD | 6 (20.7) | 8 (27.6) |
Hypercholesterolemia | 22 (75.9) | 26 (89.7) |
Chronic renal failure | 3 (10.3) | 6 (20.7) |
Diabetes mellitus | 8 (27.6) | 6 (20.7) |
ASA score, mean ± SD | 3.0 ± 0.27 | 2.9 ± 0.41 |
ASA class, n (%) | ||
ASA1 | 0 (0.0) | 0 (0.0) |
ASA2 | 1 (3.4) | 4 (13.8) |
ASA3 | 27 (93.1) | 24 (82.8) |
ASA4 | 1 (3.4) | 1 (3.4) |
Preoperative Hb, mean ± SD, g/dL | 12.3 ± 1.8 | 12.4 ± 2.2 |
Preoperative creatinine, median (IQR), µmol/L | 73 (62 to 98) | 87 (66 to 108) |
NIRS at baseline†, mean ± SD | ||
Regional cerebral oxygenation, % | 60.8 ± 9.6 | 59.5 ± 9.1 |
Regional biceps muscle oxygenation, % | 69.8 ± 8.9 | 68.2 ± 9.8 |
. | Trigger < 8 g/dL (n = 29) . | Trigger < 9.7 g/dL (n = 29) . |
---|---|---|
Age, mean ± SD, y | 71.3 ± 9.4 | 73.7 ± 7.3 |
Male sex, n (%) | 19 (65.5) | 18 (62.1) |
BMI, mean ± SD, kg/m2 | 25.3 ± 5.8 | 24.8 ± 3.8 |
Operation, n (%) | ||
Lower limb bypass | 17 (58.6) | 16 (55.2) |
Abdominal aortic aneurysm* | 12 (41.4) | 13 (44.8) |
Time of randomization, n (%) | ||
The day before surgery | 2 (6.9) | 3 (10.3) |
During surgery | 20 (69.0) | 21 (72.4) |
After end of surgery | 7 (24.1) | 5 (17.2) |
Any cardiovascular disease, n (%) | 26 (89.7) | 23 (79.3) |
Lower extremity artery disease | 20 (69.0) | 17 (58.6) |
Claudication | 4 (13.8) | 1 (3.4) |
Pain at rest | 4 (13.8) | 5 (17.2) |
Wound/gangrene | 12 (41.4) | 11 (37.9) |
Angina | 3 (10.3) | 5 (17.2) |
Stroke or TIA | 8 (27.6) | 5 (17.2) |
Previous CABG or PCI | 3 (10.3) | 5 (17.2) |
Congestive heart failure | 1 (3.4) | 2 (6.9) |
Heart valve disease | 3 (10.3) | 4 (13.8) |
Acute myocardial infarction | 0 (0.0) | 6 (20.7) |
Pacemaker | 0 (0.0) | 0 (0.0) |
Any cardiovascular risk factor, n (%) | 29 (100.0) | 28 (96.6) |
Arterial hypertension | 19 (65.5) | 22 (75.9) |
Smoker | 12 (41.4) | 11 (37.9) |
COPD | 6 (20.7) | 8 (27.6) |
Hypercholesterolemia | 22 (75.9) | 26 (89.7) |
Chronic renal failure | 3 (10.3) | 6 (20.7) |
Diabetes mellitus | 8 (27.6) | 6 (20.7) |
ASA score, mean ± SD | 3.0 ± 0.27 | 2.9 ± 0.41 |
ASA class, n (%) | ||
ASA1 | 0 (0.0) | 0 (0.0) |
ASA2 | 1 (3.4) | 4 (13.8) |
ASA3 | 27 (93.1) | 24 (82.8) |
ASA4 | 1 (3.4) | 1 (3.4) |
Preoperative Hb, mean ± SD, g/dL | 12.3 ± 1.8 | 12.4 ± 2.2 |
Preoperative creatinine, median (IQR), µmol/L | 73 (62 to 98) | 87 (66 to 108) |
NIRS at baseline†, mean ± SD | ||
Regional cerebral oxygenation, % | 60.8 ± 9.6 | 59.5 ± 9.1 |
Regional biceps muscle oxygenation, % | 69.8 ± 8.9 | 68.2 ± 9.8 |
There was no between-group difference in race, as all patients were white. The only statistically significant baseline difference between groups was previous AMI (P = .023).
ASA, American Society of Anesthesiologists; BMI, body mass index; CABG, coronary artery bypass grafting; COPD, chronic obstructive pulmonary disease; PCI, percutaneous coronary intervention; TIA, transient ischemic attack.
One patient in the AAA-stratum of the high-trigger (< 9.7g/dL) group underwent aorto-iliac bifurcated prosthesis surgery on the indication aorto-iliac occlusive disease. Otherwise, all patients in the AAA-stratum had aneurysmal disease.
Baseline was defined as the point at which the patient was normovolemic according to the goal-directed fluid strategy after anesthesia was induced and before starting surgery. The NIRS readings before O2-supplementation and induction of anesthesia were similar to this baseline (supplemental Table 3.0).