Continuous Fick Cardiac Output Measurement During Exercise by Monitoring of Mixed Venous Oxygen Saturation and Oxygen Uptake

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 < .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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Continuous monitoring of mixed venous oxygen saturation for detecting alterations in cardiac output after discontinuation of cardiopulmonary bypass

British Journal of Anaesthesia ◽

10.1093/bja/72.1.11 ◽

1994 ◽

Vol 72 (1) ◽

pp. 11-16 ◽

Cited By ~ 28

Author(s):

S. INOMATA ◽

T. NISHIKAWA ◽

M. TAGUCHI

Keyword(s):

Cardiac Output ◽

Cardiopulmonary Bypass ◽

Oxygen Saturation ◽

Continuous Monitoring ◽

Mixed Venous Oxygen Saturation ◽

Venous Oxygen Saturation ◽

Mixed Venous

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Retinal venous oxygen saturation and cardiac output during controlled hemorrhage and resuscitation

Journal of Applied Physiology ◽

10.1152/japplphysiol.01197.2001 ◽

2003 ◽

Vol 94 (3) ◽

pp. 891-896 ◽

Cited By ~ 21

Author(s):

Kurt R. Denninghoff ◽

Matthew H. Smith ◽

Art Lompado ◽

Lloyd W. Hillman

Keyword(s):

Cardiac Output ◽

Pulmonary Artery ◽

Oxygen Saturation ◽

Femoral Artery ◽

Mixed Venous Oxygen Saturation ◽

Oxygen Level ◽

Shed Blood ◽

Venous Oxygen Saturation ◽

Retinal Artery ◽

Mixed Venous

The objective was to test calibration of an eye oximeter (EOX) in a vitiligo swine eye and correlate retinal venous oxygen saturation (SrvO2), mixed venous oxygen saturation (SvO2), and cardiac output (CO) during robust changes in blood volume. Ten anesthetized adult Sinclair swine with retinal vitiligo were placed on stepwise decreasing amounts of oxygen. At each oxygen level, femoral artery oxygen saturation (SaO2) and retinal artery oxygen saturation (SraO2) were obtained. After equilibration on 100% O2, subjects were bled at 1.4 ml · kg−1· min−1for 20 min. Subsequently, anticoagulated shed blood was reinfused at the same rate. During graded hypoxia, exsanguination, and reinfusion, SraO2and SrvO2were measured by using the EOX, and CO and SvO2were measured by using a pulmonary artery catheter. During graded hypoxia, SraO2correlated with SaO2( r = 0.92). SrvO2correlated with SvO2( r = 0.89) during exsanguination and reinfusion. SvO2and SrvO2correlated with CO during blood removal and resuscitation ( r = 0.92). Use of vitiligo retinas improved the calibration of EOX measurements. In this robust hemorrhage model, SrvO2correlates with CO and SvO2across the range of exsanguination and resuscitation.

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