Tissue Perfusion Monitoring in Anesthetic Conduction of Risk Patients in Limited Resource Scenarios

The main objective of the anesthesiologist during surgery is to ensure adequate tissue perfusion. To guide the anesthetic-surgical process, the anesthesiologist uses non-invasive or invasive monitoring techniques, according to the clinical judgment of the risk associated with the physical condition of the patient and the size of the surgery, which allow measuring and monitoring ventilation, oxygenation, cardiovascular function, temperature, metabolism, level of muscle relaxation and state of consciousness of the patient. Achieving the best hemodynamic coupling or coherence between macro and microcirculation will ultimately determine the good end result in high-risk surgical patients. To evaluate the proper functioning of the microvasculature, the comparative measurement of hemogasometric variables taken in arterial blood and central venous blood samples (called arterio-venous oxygen and carbon dioxide differences, lactate levels and venous saturation) is postulated. It is known that all of them document the interactions between systemic blood flow, tissue supply and oxygen consumption.

Keywords: Tissue perfusion monitoring, lactate, venous-to-arterial carbon dioxide difference, central venous oxygen saturation.