Balancing pulmonary and systemic arterial flows in parallel circulations: the value of monitoring system venous oxygen saturations

1997 ◽  
Vol 7 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Christopher J. Riordan ◽  
Flemming Randsbaek ◽  
John H. Storey ◽  
William D. Montgomery ◽  
William P. Santamore ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Congenital Heart Defects ◽  
Oxygen Delivery ◽  
Congenital Heart ◽  
Heart Defects ◽  
Arterial Oxygen Saturation ◽  
Limited Range ◽  
Arterial Oxygen ◽  
Flow Ratio ◽  
Venous Oxygen Saturation

AbstractAccurate bedside assessment of the ratio of pulmonary to systemic flow (Qp/Qs ratio, referred to as “the flow ratio” or “the ratio”) plays an important role in the management of many congenital heart defects, especially the complexes unified by univentricular atrioventricular connections. Arterial oxygen saturation can be a misleading measure of the ratio, and may not reflect derangements until they are quite large. Theoretical analysis suggests that systemic venous oxygenation may be a better indicator of the ratio. To examine this, we created a widely patent atrial septal defect in neonatal piglets (weight =4–6.5 kg, n=6). Snares aruond the aorta and pulmonary trunk were adjusted to alter the flow ratio from 0.1 to 6.5. Venous oxygen saturations, measured in the mid-inferior caval vein, were at a maximum at a ratio about 1, and declined rapidly with increases or decreases in the ratio beyond a limited range. The venous oxygen saturation was found to vary much more than arterial oxygen saturation, with arterial oxygen saturation only falling when the ratio dropped below 0.5. Oxygen delivery (Oxygen Content x Cardiacoutput) was found to parallel closely systemic venous oxygen saturation, and was at a maximum at the same ratio that produced a maximum value of systemic venous oxygen saturation. The study suggests that systemic venous oxygen saturation provides a better estimate than does systemic arterial oxygen saturationof the flow ratio and oxygen delivery. Interventions that maximize systemic venous oxygen saturation should maximize oxygen delivery, and determination of systemic venous oxygen saturation should be a helpful addition in managing children with a number of congenital heart defects.

Oxygen transport in the critically ill

2016 ◽  
Author(s):  
Stephan M. Jakob ◽  
Jukka Takala
Keyword(s):  
Oxygen Consumption ◽  
Oxygen Saturation ◽  
Oxygen Transport ◽  
Oxygen Delivery ◽  
Arterial Oxygen Saturation ◽  
Lactate Concentration ◽  
Mixed Venous Oxygen Saturation ◽  
Arterial Oxygen ◽  
Venous Oxygen Saturation ◽  
Mixed Venous

Adequate oxygen delivery is crucial for organ survival. The main determinants of oxygen delivery are cardiac output, haemoglobin concentration, and arterial oxygen saturation. The adequacy of oxygen delivery also depends on oxygen consumption, which may vary widely. Mixed venous oxygen saturation reflects the amount of oxygen not extracted by the tissues, and therefore provides useful information on the relationship between oxygen delivery and oxygen needs. If not in balance, tissue hypoxia may ensue and arterial lactate concentration increases. This occurs at higher oxygen delivery rates in acute compared with chronic diseases where metabolic adaptions often occur. Arterial and mixed venous oxygen saturation are related to each other. The influence of mixed venous saturation on arterial saturation increases with an increasing intrapulmonary shunt. This chapter discusses interactions between the components of oxygen transport and how they can be evaluated. Various methods for measuring tissue oxygenation and oxygen consumption are also presented, together with their limitations.

scholarly journals Pulse Oximetry During the First 24 Hours as a Screening Tool For Congenital Heart Defects

2017 ◽  
Vol 3 (1) ◽  
pp. 12-17
Author(s):  
Mihaela Patriciu ◽  
Andreea Avasiloaiei ◽  
Mihaela Moscalu ◽  
Maria Stamatin
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Sensitivity And Specificity ◽  
Congenital Heart Defects ◽  
Screening Test ◽  
Congenital Heart ◽  
Heart Defects ◽  
Blood Oxygen ◽  
Blood Oxygen Saturation ◽  
Routine Pulse Oximetry

Abstract Introduction: Although screening for congenital heart defects (CHD) relies mainly on antenatal ultrasonography and clinical examination after birth, life-threatening cardiac malformations are often not diagnosed before the patient is discharged. Aim: To assess the use of routine pulse oximetry in the delivery room and at 24 hours postpartum, and to study its feasibility as a screening test for CHD. Material and Methods: In this prospective study, all infants born in “Cuza Voda” Maternity Hospital, Iasi, Romania, were enrolled over a thirteen-month period. Preductal oximetry was assessed during the first hour, and postductal oximetry was evaluated at twenty-four hours postpartum. Data were then analyzed to establish the sensitivity and specificity of pulse oximetry, as a screening test for CHD. Results: 5406 infants were included in the study, with a mean gestational age of 38.2 weeks and a mean birth weight of 3175 grams. During the first minute, blood oxygen saturation varied between 40% and 90% and at 24 hours of life, it ranged between 90% and 100%. Following oximetry assessment, 14 infants with critical CHD were identified. Blood oxygen saturation values in infants with CHD were lower throughout the entire period of evaluation. Pulse oximetry had good sensitivity and specificity at 1 hour (Se=87.5%, Sp=95.5%) and 24 hours (Se=92.5%, Sp=97.4%) for the diagnosis of CHD. Blood oxygen saturation values at one minute, 1 hour and 24 hours are strong discriminative parameters for the early diagnosis of CHD. Conclusion: Routine pulse oximetry during the first 24 hours postpartum represents an early indicator of CHD to facilitate timely intervention. Pulse oximetry provides excellent sensitivity and specificity and has tremendous potential as a standard screening test for CHD during the first 24 hours of life.

scholarly journals Head growth in fetuses with isolated congenital heart defects: lack of influence of aortic arch flow and ascending aorta oxygen saturation

2016 ◽  
Vol 48 (3) ◽  
pp. 357-364 ◽  
Author(s):  
F. A. R. Jansen ◽  
E. W. van Zwet ◽  
M. E. B. Rijlaarsdam ◽  
E. Pajkrt ◽  
C. L. van Velzen ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Aortic Arch ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Ascending Aorta ◽  
Head Growth

Effects of protoveratrine on coronary blood flow of the renal hypertensive dog

1963 ◽  
Vol 204 (5) ◽  
pp. 895-898 ◽  
Author(s):  
James W. West ◽  
Elwood L. Foltz
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Oxygen Saturation ◽  
Coronary Blood Flow ◽  
Arterial Oxygen Saturation ◽  
Renal Hypertension ◽  
Peripheral Resistance ◽  
Arterial Oxygen ◽  
Arterial Blood ◽  
Venous Oxygen Saturation

In renal hypertension, protoveratrine decreased coronary blood flow, cardiac oxygen consumption, arterial and venous oxygen saturation, coronary arteriovenous oxygen difference, mean arterial blood pressure, cardiac output, cardiac work, cardiac efficiency, cardiac rate, total peripheral resistance, coronary resistance, respiratory rate, and minute volume. The decrease was significant in all functions except coronary blood flow, coronary venous oxygen saturation, and cardiac output. The results of these experiments indicate that in the renal hypertensive animal, a therapeutically beneficial effect was derived from protoveratrine on the circulation by its ability to decrease the work of the heart (lowering the elevated mean arterial pressure) and the coronary vascular resistance while maintaining coronary blood flow and cardiac output within normal levels. The less advantageous effect of protoveratrine on circulation resulted from its respiratory inhibiting effect which reduced the arterial blood oxygen saturation. Although a small decline in coronary venous oxygen saturation was noted, the coronary flow and oxygen delivery in face of the reduced arterial oxygen saturation was apparently adequate to maintain a normal cardiac activity.

Investigating spectroscopic measurement of sublingual veins and tissue to estimate central venous oxygen saturation

2021 ◽  
pp. 1-9
Author(s):  
Aslinur Sircan-Kucuksayan ◽  
Oktay Eray ◽  
Murat Buyukaksu ◽  
Birce Gumus ◽  
Oguz Dursun ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Near Infrared ◽  
Arterial Oxygen Saturation ◽  
Central Venous Oxygen Saturation ◽  
Arterial Oxygen ◽  
Central Venous ◽  
Venous Oxygen Saturation ◽  
Oxygenation Status

BACKGROUND: Venous oxygen saturation reflects venous oxygenation status and can be used to assess treatment and prognosis in critically ill patients. A novel method that can measure central venous oxygen saturation (ScvO2) non-invasively may be beneficial and has the potential to change the management routine of critically ill patients. OBJECTIVE: The study aims to evaluate the potential of sublingual venous oxygen saturation (SsvO2) to be used in the estimation of ScvO2. METHODS: We have developed two different approaches to calculate SsvO2. In the first one, near-infrared spectroscopy (NIRS) measurements were performed directly on the sublingual veins. In the second approach, NIRS spectra were acquired from the sublingual tissue apart from the sublingual veins, and arterial oxygen saturation was measured using a pulse oximeter on the fingertip. RESULTS: Twenty-six healthy subjects were included in the study. In the first and second approaches, average SsvO2 values were 75.0% ± 1.8 and 75.8% ± 2.1, respectively. The results of the two different approaches were close to each other and similar to ScvO2 of healthy persons (> 70%). CONCLUSION: Oxygen saturation of sublingual veins has the potential to be used in intensive care units, non-invasively and in real-time, to estimate ScvO2.

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