Document Detail

Venous oxygen saturation during normovolaemic haemodilution in the pig.
MedLine Citation:
PMID:  16095457     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hypovolaemia may be considered to represent a volume-restricted cardiac output (CO), but CO varies inversely with the haemoglobin concentration (Hb) and a maximal mixed venous oxygen saturation (SvO2) may be a better target for volume administration than a maximal CO. METHODS: In 10 anaesthetized pigs, volume loading with 6% hydroxyethyl starch was performed to obtain a maximal SvO2 followed by normovolaemic haemodilution with 6% hydroxyethyl starch. RESULTS: Volume loading increased SvO2 from 55.0+/-5.2% to 64.8+/-9.0% (mean+/-SD) associated with an increase in CO (2.3+/-0.4 to 3.5+/-0.9 l/min) and central venous oxygen saturation (ScvO2; 68.2+/-9.3% to 79.4+/-7.2%; P<0.05). Heart rate (HR), mean arterial (MAP), central venous (CVP), pulmonary arterial mean (PAMP), and occlusion pressures (PAOP) increased as well (P<0.05). In contrast, during progressive haemodilution, SvO2 and ScvO2 remained statistically unchanged until the haemoglobin concentration had decreased from 5.5+/-0.4 to 2.9+/-0.2 mM, while CO and HR increased at a haemoglobin value of 4.4+/-0.4 and 4.0+/-0.4 mM and CVP and PAOP decreased at a haemoglobin of 4.0+/-0.4 and 2.9+/-0.2 mM, respectively (P<0.05) leaving MAP unaffected. CONCLUSION: This study found that volume loading increased cardiac output and mixed and central venous oxygen saturations in parallel, but during normovolaemic haemodilution an increase in cardiac output left mixed and central venous oxygen saturations statistically unchanged until haemoglobin concentration was reduced by approximately 50%. Accordingly, volume therapy should be directed to maintain a high venous oxygen saturation rather than a change in cardiac output.
T Krantz; J Warberg; N H Secher
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  49     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-12     Completed Date:  2005-11-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  1149-56     Citation Subset:  IM    
Copenhagen Muscle Research Center, Department of Anesthesia, Rigshospitalet, Denmark.
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MeSH Terms
Blood Gas Analysis / methods
Blood Pressure / drug effects
Heart Rate / drug effects
Hemodilution / methods*
Hemodynamics / drug effects
Hemoglobins / drug effects
Hetastarch / administration & dosage
Models, Animal
Oxygen / blood*
Plasma Substitutes / administration & dosage
Veins / physiology*
Reg. No./Substance:
0/Hemoglobins; 0/Plasma Substitutes; 7782-44-7/Oxygen; 9005-27-0/Hetastarch

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