scholarly journals Positive central-mixed venous oxygen saturation gradients: high oxygen saturation in the inferior vena cava confirms high splanchnic oxygen extraction

Critical Care ◽  
2011 ◽  
Vol 15 (S1) ◽  
Author(s):  
A Reintam Blaser ◽  
T Correa ◽  
S Djafarzadeh ◽  
M Vuda ◽  
J Takala ◽  
...  

2018 ◽  
Vol 02 (02) ◽  
pp. 057-060
Author(s):  
Naresh Kumar Agarwal ◽  
Arun Subramanian

AbstractVenous oxygen saturation has been traditionally used as a marker for tissue hypoxia. A wide range of factors can affect it. Literature abounds with articles on the use of the same in decision making and clinical management of patients in shock. Likewise, the application of venous saturation in patients undergoing cardiac and noncardiac surgery has been demonstrated. The controversy as to whether superior vena cava oxygen saturation can replace the traditional mixed venous oxygen saturation is never ending. Irrespective of the body of evidence, it is recommended that clinical decision should not be based on a single value, and a range of values needs to be incorporated to differentiate a critically ill from a noncritically ill patient.





2005 ◽  
Vol 103 (2) ◽  
pp. 249-257 ◽  
Author(s):  
Michael H. Dueck ◽  
Markus Klimek ◽  
Stefan Appenrodt ◽  
Christoph Weigand ◽  
Ulf Boerner

Background Previous studies found contradictory results regarding the question whether mixed venous oxygen saturation (Svo2) and central venous oxygen saturation (Scvo2) are equivalent. The inconsistency of study results may result from different study designs and different, partly questionable, statistical approaches. Methods The authors performed a prospective clinical trial comparing individual oxygen saturation values as well as the trend of values in blood from the superior vena cava (Scvo2), the right atrium (Srao2), and the pulmonary artery (Svo2) during varying hemodynamic situations. The subjects were 70 patients scheduled to undergo elective neurosurgical operations in the sitting position. Oxygen saturation was measured photospectrometrically in blood samples simultaneously taken at four different time points during supine and sitting positions. Statistical analysis was performed following the recommendations of Bland and Altman. Results Five hundred two comparative sets of measurements were obtained. Ninety-five percent limits of agreement ranging from +/-6.83 to +/-9.30% for single values were interpreted as clinically unacceptable. In contrast, correlations between changes of Svo2 and Scvo2 as well as of Svo2 and Srao2 were interpreted as clinically acceptable (R > or = 0.755, Pearson correlation coefficient; P < or = 0.0001). Conclusions In this sample of patients, exact numerical values of Scvo2 and Srao2 are not equivalent to those of Svo2 in varying hemodynamic conditions. However, for clinical purposes, the trend of Scvo2 may be substituted for the trend of Svo2. In addition, previous studies investigating the agreement between Svo2 and Scvo2 were found to be lacking in their chosen statistical approaches.









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