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SOP » Anaesthesia protocol » Monitoring
Last modified on Tue 15 Jul 2014

We monitor also blood sugar level and keep the glucose level between 80-120 mg/dl.

Much controversy persists on the type of monitoring that is adequate for OPCAB surgery. While we agree that the importance of a Thermodilution catheter in routine CABG should not be over-emphasized we plead for a reconsideration of its use in OPCAB surgery.

Both ECG and 2-dimensional TEE have important limitations in monitoring ischemia during displacement of the heart during OPCAB grafting of the posterior and lateral walls of the heart.
Perhaps the most important hemodynamic variable in the monitoring of ischemia is the Left ventricular end-diastolic pressure. Some groups prefer to introduce a left atrial catheter while others (including our group) rely on the PcWP as a surrogate for LVEDP. Indeed LV stiffness is one of the earliest signs of myocardial ischemia.
2-dimensional TEE is useful in the assessment of regional wall motion in the pre- and post revascularization period. During revascularization the visibility of the heart may be compromised due to loss of acoustic coupling.