Measurement of Oxygen Consumption and Arterial-Venous Oxygen Saturation following Total Artificial Heart Implantation

1993 ◽  
Vol 16 (3) ◽  
pp. 135-140 ◽  
Author(s):  
P.D. Robison ◽  
G.M. Pantalos ◽  
J.W. Long ◽  
R.S. Bliss ◽  
D.K. Price ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Oxygen Consumption ◽  
Oxygen Delivery ◽  
Artificial Heart ◽  
Tissue Perfusion ◽  
Oxygen Metabolism ◽  
Total Artificial Heart ◽  
Oxygen Utilization ◽  
Venous Oxygen Saturation ◽  
Mixed Venous

Current algorithms for control of the total artificial heart are directed at maintaining hemodynamic homeostasis. Future control systems will also need to modify cardiac output in response to metabolic needs. This study was undertaken to evaluate oxygen metabolism monitoring as an indicator of the adequacy of organ and tissue perfusion. Following recovery from implantation of the Utah-100 pneumatic total artificial hearts, five calves (85 to 95 kg) underwent placement of fiberoptic oxymetry catheters to determine mixed venous and arterial oxygen saturations. By continuously measuring oxygen consumption with a gas analyzer, oxygen utilization and delivery were determined. In the awake calves, at-rest cardiac output was varied to produce hyperperfused and hypoperfused conditions while the adequacy of tissue perfusion was assessed with continuous mixed venous oxymetry and confirmed with serum lactate (Lact) levels. Inadequate tissue perfusion (Lact > 1.0 mmol/L) was evidenced by a mixed venous oxygen saturation <40%, oxygen delivery of < 200.0 milliliters/minute/m2), and oxygen delivery to utilization ratio of < 1.8 during the hypoperfusion conditions of the experiment. By accounting for oxygen consumption, the ratio of oxygen delivery to oxygen utilization was predictive of the adequacy of tissue perfusion. These results suggest that continuous oxygen metabolism monitoring may be useful as a physiologic control modifier to maintain total artificial heart output sufficient to meet physiologic needs, while avoiding hyperperfusion, unnecessary wear and deterioration of the implanted device due to excessive heart rates.

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.

The Development of a Control Method for a Total Artificial Heart Using Mixed Venous Oxygen Saturation

1999 ◽  
Vol 23 (3) ◽  
pp. 235-241 ◽  
Author(s):  
Makoto Nakamura ◽  
Toru Masuzawa ◽  
Eisuke Tatsumi ◽  
Yoshiyuki Taenaka ◽  
Tomomichi Nakamura ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Artificial Heart ◽  
Control Method ◽  
Mixed Venous Oxygen Saturation ◽  
Total Artificial Heart ◽  
Venous Oxygen Saturation ◽  
Mixed Venous

Oxygen Consumption and Delivery in Critical Illness

2020 ◽  
pp. 25-36
Author(s):  
Hans Tregear ◽  
Brigid C. Flynn
Keyword(s):  
Oxygen Consumption ◽  
Lactic Acidosis ◽  
Oxygen Saturation ◽  
Oxygen Delivery ◽  
Mixed Venous Oxygen Saturation ◽  
Central Venous ◽  
Arterial Blood Gas ◽  
Venous Oxygen Saturation ◽  
Mixed Venous ◽  
Oxygen Consumption And Delivery

This chapter evaluates the importance of identifying the oxygen delivery and oxygen consumption balance in critically ill patients. Mixed venous oxygen saturation is a valuable marker of oxygen consumption and delivery in an intensive care unit patient. Organ perfusion can be improved by optimizing all components of the oxygen delivery calculation and decreasing oxygen consumption, if indicated. Several tools that aid in this assessment include pulmonary artery catheter–derived mixed venous oxygen saturation, central venous line–derived central venous saturation, cardiac ultrasonography, and laboratory values such as the arterial blood gas and lactate levels. The chapter also discusses hyperlactatemia. Hyperlactatemia can be due to anaerobic metabolism (type A lactic acidosis) or aerobic metabolism (type B lactic acidosis).

Control of a Total Artificial Heart using Mixed Venous Oxygen Saturation

ASAIO Journal ◽  
1999 ◽  
Vol 45 (5) ◽  
pp. 460-465 ◽  
Author(s):  
MAKOTO NAKAMURA ◽  
TORU MASUZAWA ◽  
EISUKE TATSUMI ◽  
YOSHIYUKI TAENAKA ◽  
TAKASHI OHNO ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Artificial Heart ◽  
Mixed Venous Oxygen Saturation ◽  
Total Artificial Heart ◽  
Venous Oxygen Saturation ◽  
Mixed Venous

Mixed Venous Oxygen Saturation as a Promising Parameter for Physiologic Control of Total Artificial Heart

ASAIO Journal ◽  
2000 ◽  
Vol 46 (6) ◽  
pp. 761-766 ◽  
Author(s):  
Makoto Nakamura ◽  
Akihiko Homma ◽  
Eisuke Tatsumi ◽  
Kunihiro Uesho ◽  
Yoshiyuki Taenaka ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Artificial Heart ◽  
Mixed Venous Oxygen Saturation ◽  
Total Artificial Heart ◽  
Venous Oxygen Saturation ◽  
Mixed Venous

Can measurement of mixed venous oxygen saturation replace measurement of cardiac output in patients with advanced heart failure?

1998 ◽  
Vol 7 (5) ◽  
pp. 374-380 ◽  
Author(s):  
A Gawlinski
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Ejection Fraction ◽  
Oxygen Saturation ◽  
Advanced Heart Failure ◽  
Mixed Venous Oxygen Saturation ◽  
Venous Oxygen Saturation ◽  
Vasoactive Medications ◽  
Mixed Venous ◽  
Low Ejection Fraction

BACKGROUND: Nursing care of patients with advanced heart failure with low ejection fraction requires strict management of IV fluids. Measurement of mixed venous oxygen saturation offers advantages over measurement of cardiac output because no administration of fluid is required and data are obtained continuously. OBJECTIVES: To determine the relationship between mixed venous oxygen saturation and cardiac output in patients with advanced heart failure who have low ejection fraction and to determine if use of vasoactive medications alters the relationship between mixed venous oxygen saturation and cardiac output. METHODS: Simultaneously obtained measurements of mixed venous oxygen saturation and cardiac output were compared in 42 patients with advanced heart failure with ejection fractions of 30% or less (mean, 19.5%). RESULTS: Correlation between mixed venous oxygen saturation and cardiac output was r = 0.54 (P &lt; .001). For subjects not receiving vasoactive medications (n = 28), r = 0.52 (P = .004); for those receiving vasoactive medications (n = 14), r = 0.57 (P = .03). CONCLUSIONS: Similar correlations in the groups receiving and not receiving vasoactive medications suggest that even with pharmacological support, changes in mixed venous oxygen saturation may not be reflected by concomitant changes in cardiac output. Measurement of mixed venous oxygen saturation should not replace measurement of cardiac output for clinical decision making in patients with advanced heart failure with low ejection fraction.

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