Document Detail


Effect of vasoactive treatment on the relationship between mixed venous and regional oxygen saturation.
MedLine Citation:
PMID:  1935155     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the relationship between the mixed venous (SvO2), hepatic, and femoral venous oxygen saturations before and during sympathomimetic drug infusions. DESIGN: Case series. SETTING: Tertiary care center. PATIENTS: Twenty-four ICU patients: postoperative open-heart surgery patients (n = 12), patients with septic shock (n = 8), and patients with acute respiratory failure (n = 4). INTERVENTIONS: In postoperative open-heart surgery patients and patients with respiratory failure, cardiac output was increased by at least 25% following therapy with either dobutamine or dopamine. Patients with septic shock were treated with either dopamine or norepinephrine to correct hypotension. MEASUREMENTS AND MAIN RESULTS: Vasoactive drug infusions increased cardiac index and oxygen delivery by 34% and oxygen consumption by 8%. SvO2 increased (62.6 +/- 6.7% vs. 69.5 +/- 6.0%, p less than .001). Although cardiac index was the most important determinant of SvO2, the correlation between cardiac index and SvO2 was weak (r2 = .32). The hepatic and femoral venous saturations also increased (49.0 +/- 12.1% vs. 59.4 +/- 9.8%, p less than .01, and 51.9 +/- 16.6% vs. 63.4 +/- 9.8%, p less than .001, respectively) in response to vasoactive treatment. The mean gradient between SvO2 and hepatic venous saturation was 11.9 +/- 8.7% and was independent of the clinical condition and baseline SvO2. The hepatic venous oxygen saturation increased in parallel with SvO2 regardless of the initial SvO2 value. CONCLUSIONS: The individual values of SvO2 have no predictive value concerning regional oxygen transport. The parallel increase in SvO2 and hepatic venous oxygen saturation suggests that the vasoactive treatment did not compromise splanchnic oxygenation.
Authors:
E Ruokonen; J Takala; A Uusaro
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  19     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1991 Nov 
Date Detail:
Created Date:  1991-11-26     Completed Date:  1991-11-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1365-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Intensive Care, Kuopio University Hospital, Finland.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Coronary Artery Bypass*
Dobutamine / pharmacology
Dopamine / pharmacology
Humans
Liver Circulation / drug effects
Norepinephrine / pharmacology
Oxygen / blood*
Oxygen Consumption / drug effects*
Respiratory Insufficiency / physiopathology*
Shock, Septic / physiopathology*
Vasoconstrictor Agents / pharmacology*
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; 34368-04-2/Dobutamine; 51-41-2/Norepinephrine; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
Crit Care Med. 1993 Jan;21(1):165-7   [PMID:  8420725 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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