OXYGEN DELIVERY AS A FACTOR IN THE DEVELOPMENT OF FATAL POSTOPERATIVECOMPLICATIONS AFTER ESOPHAGECTOMY

Background This study was designed to assess the impact of oxygen tran sport variables on outcome in 115 patients undergoing elective surgery for oesophageal carcinoma. Methods Haemodynamic parameters were deter mined using a Swan-Ganz catheter in all patients on the day before ope ration, 6 h after operation, and daily for the first 4 days after oper ation, Results Oxygen delivery and consumption at 6 h were significant ly higher in survivors than in nonsurvivors. However, oxygen delivery and consumption in both groups did not differ significantly after post operative day 1. Of 17 patients with oxygen delivery levels lower than 445 mi min(-1) m(-2) at 6 hi eight died in hospital. Oxygen delivery in patients who developed either an anastomotic leak or severe pneumon ia was significantly lower 6 h after surgery. Lower levels of oxygen d elivery preceded postoperative complications. Conclusion Oxygen delive ry 6 h after oesophagectomy correlates with postoperative complication s and may be a determinant of hospital mortality.