Blood pressure and free flap oxygenation in head and neck cancer patients

Acta Otolaryngol. 2011 Jul;131(7):757-63. doi: 10.3109/00016489.2011.554438. Epub 2011 Mar 17.

Abstract

Conclusion: This study suggests that although oxygen partial pressure in tissue (p(ti)O(2)) measurement is a feasible method for continuous postoperative monitoring of free flaps, low correlation between blood pressure (BP) and p(ti)O(2) might predict compromised overall outcome. Thus, it is of utmost importance to keep the BP optimal for adequate perfusion of re-anastomosed tissue transfers.

Objective: Optimal BP is an important factor in assuring adequate blood flow in a free flap. Tissue oxygenation in free flaps as a postoperative monitoring target is in routine clinical use in some clinics. Correlation between p(ti)O(2) and systemic BP was investigated.

Methods: Ten consecutive patients underwent resection of head and neck squamous cell carcinoma followed by microvascular reconstruction with a free microvascular flap. P(ti)O(2) of each flap was continuously monitored for 3 postoperative days with a polarographic measurement system. BP was measured invasively and continuously during the operation and during the first postoperative day at the intensive care unit. The correlation coefficient between p(ti)O(2) and BP was analysed.

Results: The correlation coefficient between p(ti)O(2) and BP was relatively high in all patients with uneventful flap survival (r (mean) = 0.63, n = 5). In flaps with haemodynamic problems or compromised flap vitality the correlation appeared low (r(mean) = -0.02, n = 5).

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Blood Pressure / physiology*
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / physiopathology
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Follow-Up Studies
  • Free Tissue Flaps / physiology*
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / physiopathology
  • Head and Neck Neoplasms / surgery
  • Humans
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Monitoring, Physiologic / methods*
  • Mouth Neoplasms / diagnosis
  • Mouth Neoplasms / physiopathology
  • Mouth Neoplasms / surgery*
  • Neoplasm Staging
  • Oxygen Consumption / physiology*
  • Postoperative Period
  • Prospective Studies
  • Regional Blood Flow
  • Treatment Outcome