Evaluation of the measurement of the intraoperative transcutaneous partial pressure of oxygen (PtcO₂) as a prognostic indicator in vascular reconstruction

Abstract

The intraoperative transcutaneous partial pressure of oxygen (PtcO₂) was used to monitor 58 vascular reconstructive surgery procedures in 54 patients. The study comprised three groups: Group A (24 limbs without any ischemic symptoms or signs), Group B (45 limbs with intermittent claudication), and Group C (12 limbs with ischemic rest pain, ulceration, and gangrene). In addition in 31 patients the chest wall was monitored simultaneously as a control. The results showed that the PtcO₂ values increased immediately and significantly to varying degrees and at varying speeds after unclamping. The controls had higher values than Group A (P>0.05), Group B (P<0.05), and Group C (P<0.05) patients. Further study showed that there were no significant differences between the maximal values in the limbs with good distal vessel run-off in Groups A, B, and C, and in the controls (P>0.05). It is thus concluded that effective vascular reconstruction in the limbs is indicated by a rapid and marked increase of both the PtcO₂ value and the response value, while with a slow and low increase of the value, early graft failure and poor distal vessel run-off should be suspected. We believe that this monitoring method dynamically reflects the functional state during vascular reconstruction and is clinically valid.