| Lack of equivalence between central and mixed venous oxygen saturation. | |
| | |
MedLine Citation:
|
PMID: 15596689 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
STUDY OBJECTIVE: We compared paired samples of central venous O(2) saturation (Scvo(2)) and mixed venous O(2) saturation (Svo(2)) to test the hypothesis that Scvo(2) is equivalent to Svo(2). We also compared O(2) consumption (Vo(2)) computed with Scvo(2) (Vo(2)cv) to that computed with Svo(2) (Vo(2)v). DESIGN: Prospective, sequential, observational study. SETTING: Combined medical-surgical ICU. PATIENTS: Fifty-three individuals > 18 years of age of either sex who required a pulmonary artery catheter (PAC) to guide fluid therapy. Subjects were identified as postsurgical (32 patients) or medical (21 patients) according to their ICU admission diagnosis. INTERVENTIONS: A PAC was inserted through the internal jugular or subclavian veins. Care was taken to place the PAC proximal port approximately 3 cm above the tricuspid valve. Blood samples were drawn from the proximal and distal ports in random order. An arterial blood sample also was drawn. MEASUREMENTS: Cardiac output in triplicate, systemic pressure, and central pressure. We analyzed blood samples for hemoglobin concentration and O(2) saturation (So(2)). Data were compared by correlation analysis and by the method of Bland and Altman. RESULTS: Svo(2) was consistently lower than Scvo(2) (p < 0.0001), with a mean (+/-SD) bias of -5.2 +/- 5.1%. Similar differences in Scvo(2) and Svo(2) were present within each subgroup (p < 0.001). A lower Svo(2) resulted in Vo(2)v values that were higher than the Vo(2)cv values for all patients in the study (mean Vo(2)v, 236.7 +/- 103.4 mL/min; mean Vo(2)cv, 191.1 +/- 84.0 mL/min; p < 0.001) as well as for patients within each subgroup (p < 0.001). CONCLUSIONS: Measurements of Scvo(2) and Svo(2) were not equivalent in this sample of critically ill patients. Moreover, substituting Scvo(2) for Svo(2) in the calculation of Vo(2) produced unacceptably large errors. The decrease in So(2) between Scvo(2) to Svo(2) may result from the mixing of atrial and coronary sinus blood. As such, this difference may be a marker of myocardial O(2) consumption. |
| | |
Authors:
|
Lakhmir S Chawla; Hasan Zia; Guillermo Gutierrez; Nevin M Katz; Michael G Seneff; Muhammed Shah |
Related Documents
:
|
10972539 - Acute and chronic sympathoinhibition on carotid artery diameter of spontaneously hypert... 3942419 - Central venous access with occlusive superior central venous thrombosis. 8115629 - Mr imaging with spatial modulation of magnetization in the evaluation of chronic centra... 17998779 - External jugular groshong catheter is associated with fewer complications than a subcla... 8109419 - Carotid chemoreceptor reflex cardioinhibitory responses: comparison of their modulation... 21286489 - Cervical radiculopathy caused by vertebral artery loop formation : a case report and re... 3488719 - Spinal cord infarction following intraaortic balloon support. 18762679 - Popliteal artery pseudoaneurysm following foxhollow atherectomy: a rare complication. 7391119 - Early surgical repair in traumatic rupture of the thoracic aorta (report of 9 cases and... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Chest Volume: 126 ISSN: 0012-3692 ISO Abbreviation: Chest Publication Date: 2004 Dec |
Date Detail:
|
Created Date: 2004-12-14 Completed Date: 2005-01-18 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
|
Languages: eng Pagination: 1891-6 Citation Subset: AIM; IM |
Affiliation:
|
The George Washington University MFA, 2150 Pennsylvania Ave NW, Suite 5-404, Washington, DC 20037, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Catheterization, Swan-Ganz Critical Illness Female Heart Atria Hemoglobins / analysis Humans Intensive Care Units Male Middle Aged Oximetry / methods Oxygen / blood* Oxygen Consumption* Veins Venae Cavae |
| Chemical | |
Reg. No./Substance:
|
0/Hemoglobins; 7782-44-7/Oxygen |
| Comments/Corrections | |
Comment In:
|
Chest. 2005 Aug;128(2):1073-4; author reply 1074-5
[PMID:
16100219
]
Chest. 2006 Mar;129(3):507-8 [PMID: 16537845 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The state of intubated ICU patients: development of a two-dimensional sedation rating scale for crit...
Next Document: Outcomes up to 5 years after severe, acute respiratory failure.