Intraoperative Hypotension Attributable To Septicemia And Diagnosed By Measurement Of Central Venous Oxygen Saturation

Abstract

Intraoperative hypotension may contribute to significant post-operative morbidity and mortality. We present a case of sudden, profound intraoperative hypotension during Harrington rod revision for scoliosis. During resuscitation of the patient, measurement of the central venous oxygen saturation (CVO2) allowed us to narrow our differential diagnosis. We noted a significantly elevated CVO2 and, in the setting of hypotension, diagnosed intraoperative sepsis. After rod removal and stabilization of the patient's hemodynamics, we cancelled the remainder of the case due to the concern of bacteremia and infection of any newly placed hardware. Cultures from the wound later grew methicillin-resistant staphylococcus aureus. This case highlights the value of central venous oxygen saturation in a clinical picture to diagnose the cause of intraoperative hypotension