Central and mixed venous blood oxygen correlate well during acute normovolemic hemodilution in anesthetized pigs

Schou, Henning; Sá, Valéria Perez de; Larsson, Anders

doi:10.1111/j.1399-6576.1998.tb05104.x

Cited by 30 publications

(25 citation statements)

References 24 publications

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“…The mean difference between Svo 2 and Scvo 2 (bias) and 95% limit of agreement are given in Table 2. [12,13]. Clinical trials have demonstrated that Scvo 2 can consistently over-estimate Svo 2 in critically ill patients and that such variation is not seen in healthy individuals [14,15].…”

Section: Resultsmentioning

confidence: 99%

Comparison of central venous oxygen saturation and mixed venous oxygen saturation during liver transplantation

et al. 2009

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SummaryCentral venous catheterisation is commonly performed during major surgery and intensive care, and it would be useful if central venous oxygen saturation could function as a surrogate for mixed venous oxygen saturation. We studied 50 patients undergoing living related liver transplantation. Blood samples were taken simultaneously from central venous and pulmonary artery catheters at nine time points during the pre-anhepatic, anhepatic, and postanhepatic phases. Four hundred and fifty sets of measurement were obtained. There was a good correlation between central venous oxygen saturation and mixed venous oxygen saturation. The mean (SD) difference (95% limit of agreement) was lowest at the first time point (1.06 (0.65)%, )1.94% to 2.7%) and then increased throughout the study but remained acceptable. The change in mixed venous oxygen and central venous oxygen saturations occurred mostly in parallel and as a result changes in mixed venous oxygen saturation were reflected adequately in the change in central venous oxygen saturation. The correlation between mixed venous oxygen saturation and cardiac output was poor. True mixed venous blood is derived from a pool of venous blood entering the pulmonary artery via the great veins in the chest. It contains blood which has traversed all systemic capillary beds capable of extracting oxygen, and is thoroughly mixed by the right ventricle. It has been suggested that the most suitable sites with respect to complete mixing are the right ventricular outflow tract and pulmonary artery [1,2]. Mixed venous oxygen saturation has been shown to be a surrogate for the balance between systemic oxygen delivery and consumption during treatment of critically ill patients [3]. Maintenance and monitoring of tissue oxygenation is one of the most important goals in the care of critically ill or unstable patients. Measurement of mixed venous oxygen saturation (Svo 2 ) requires placement of a pulmonary artery catheter, which may not be feasible in all patients. However, central venous access can be easily and safely obtained in both ICU and non-ICU settings, which makes central venous oxygen saturation (Scvo 2 ) monitoring a convenient surrogate for Svo 2 . There has been considerable debate regarding whether Scvo 2 is a satisfactory substitute for Svo 2 , particularly above 65% [4][5][6]. Although the absolute values of Scvo 2 and Svo 2 differ, previous studies have shown close tracking of the two measurements across a wide range of haemodynamic conditions [7].Profound haemodynamic and metabolic changes occur during adult orthotropic liver transplantation (OLT) [5,6]. During the dissection phase the disturbance is mainly due to bleeding and hypovolemia [8], while in the anhepatic phase there may be a 50% reduction of venous return with clamping of inferior vena cava [9]. Reperfusion of the graft during the neo-hepatic stage carries the risk of systemic hypotension (postreperfusion syndrome) [10]. The relationship between Svo 2 and Scvo 2 has not assessed in such conditions where haemody...

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Section: Resultsmentioning

confidence: 99%

Comparison of central venous oxygen saturation and mixed venous oxygen saturation during liver transplantation

et al. 2009

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“…The number of subjects included ranged from seven [16] to 61 [17] and the number of comparative measurements from 27 [15] to 580 [16]. Interestingly, in some studies there was an unequal number of blood samples compared per subject, which resulted in an imbalanced statistical weight of subjects with excellent or bad correspondence between SvO 2 and ScvO 2 [16,18,19].…”

Section: Parallel Tracking Of Svo 2 and Scvomentioning

confidence: 97%

“…In an animal study Schou et al [19] concluded that during hemodilution SvO 2 and ScvO 2 are interchangeable and that monitoring of ScvO 2 is as useful as monitoring SvO 2 .…”

Section: Parallel Tracking Of Svo 2 and Scvomentioning

confidence: 98%

Venous oximetry

Marx

Reinhart

2006

Current Opinion in Critical Care

115

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Early goal-directed therapy should be implemented in the initial resuscitation of septic patients. Central venous saturation may have prognostic significance following major surgery. Further evaluation of peri-operative trends in central venous saturation is required. Measurement of central venous oxygen saturation can easily be applied in intensive care unit patients and offers a useful, indirect indicator for the adequacy of tissue oxygenation.

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“…Scalea et al [57] Baquero-Cano et al [58] Schou et al [59] Davies et al [60] Shah et al [61] Lee et al Patients in the ICU with low, medium, and high cardiac indexes.…”

Section: ••]mentioning

confidence: 99%

Central venous oxygen saturation monitoring in the critically ill patient

Rivers¹,

Ander²,

Powell³

2001

Current Opinion in Critical Care

216

117

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In the initial treatment of a critically ill patient, blood pressure, heart rate, urine output, and central venous pressure guide resuscitative efforts. Despite normalization of these variables, global tissue hypoxia may still persist and has been implicated in the development of multiorgan failure and increased mortality. Definitive management includes intensive care unit admission, pulmonary artery catheterization using mixed venous oxygen saturation (SvO2), and hemodynamic optimization. In the absence of or before definitive management, hemodynamic optimization can be performed using central venous oxygen saturation (ScvO2) as a surrogate. The physiology, technology, clinical uses, and rationale for ScvO2 monitoring are reviewed, including issues regarding physiologic equivalence to SvO2. The clinical use of ScvO2 monitoring, evidence-based outcome implications, and limitations of ScvO2 monitoring will also be examined.

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Central and mixed venous blood oxygen correlate well during acute normovolemic hemodilution in anesthetized pigs

Abstract: The findings indicate that also during hemodilution monitoring of central venous blood oxygen may be as useful as monitoring of mixed venous blood oxygen.

Cited by 30 publications

References 24 publications

Comparison of central venous oxygen saturation and mixed venous oxygen saturation during liver transplantation

Comparison of central venous oxygen saturation and mixed venous oxygen saturation during liver transplantation

Venous oximetry

Central venous oxygen saturation monitoring in the critically ill patient

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