Accuracy of continuous central venous oxygen saturation monitoring in patients undergoing cardiac surgery

被引：14

作者：

Baulig W. ^{[1
]}

Dullenkopf A. ^{[1
]}

Kobler A. ^{[1
]}

Baulig B. ^{[1
]}

Roth H.R. ^{[2
]}

Schmid E.R. ^{[1
]}

机构：

[1] Division of Cardiac Anaesthesia, Institute of Anaesthesiology, University Hospital Zurich, Zurich 8091

[2] ETH, Seminar for Statistics, Zurich, Zurich 8092

来源：

J. Clin. Monit. Comput. | 2008年 / 3卷 / 183-188期

关键词：

Cardiac surgery; Central venous oxygen saturation; Continuous monitoring; Mixed venous oxygen saturation;

D O I：

10.1007/s10877-008-9123-2

中图分类号：

学科分类号：

摘要：

Objective: Continuous assessment of central venous oxygen saturation (ScevoxO2) with the CeVOX device (Pulsion Medical Systems, Munich, Germany) was evaluated against central venous oxygen saturation (ScvO2) determined by co-oximetry. Methods: In 20 cardiac surgical patients, a CeVOX fiberoptic probe was introduced into a standard central venous catheter placed in the right internal jugular vein and advanced 2-3 cm beyond the catheter tip. After in vivo calibration of the probe, ScevoxO2, ScvO2, mixed venous oxygen saturation (SmvO2) haemoglobin (Hb), body temperature, heart rate, central venous and mean arterial pressure, and cardiac index were assessed simultaneously at 30 min intervals during surgery and at 60 min intervals during recovery in the intensive care unit. Agreement between ScevoxO2, and ScvO2 was determined by Bland-Altman analysis. Simple regression analysis was used to assess the correlation of ScevoxO2, and ScvO2 to Hb, body temperature and haemodynamic parameters. Results: Values of ScevoxO2 and ScvO2 (84 data pairs during surgery and 106 in the intensive care unit) ranged between 45-89% and 43-90%, respectively. Mean bias and limits of agreement of ScevoxO2 and ScvO2 were -0.9 (-7.9/+6.1)% during surgery and -1.2 (-10.5/+8.1)% in the intensive care unit. In 37.9% of all measured data pairs, the difference between ScevoxO2 and ScvO2 was beyond clinically acceptable limits (≥1 s.d.). Mean bias was significantly influenced by cardiac index. Sensitivity and specificity of ScevoxO2 to detect substantial (≥1 s.d.) changes in ScvO2 were 89 and 82%, respectively. Conclusions: In adult patients during and after cardiac surgery, the current version of the CeVOX device might not be the tool to replace ScvO2 determined by co-oxymetry, although sensitivity and specificity of ScevoxO2 to predict substantial changes in ScvO2 were acceptable. © Springer Science+Business Media, LLC 2008.

引用

页码：183 / 188

页数：5

共 23 条

[1]

Wilkinson A.R., Phibbs R.H., Gregory G.A., Continuous measurement of oxygen saturation in sick newborn infants, J Pediatr, 93, pp. 1016-1019, (1978)

[2]

Wilson R.F., Get the venous blood too, Am Surg, 44, pp. 396-400, (1978)

[3]

Rivers E., Nguyen B., Havstad S., Ressler J., Muzzin A., Knoblich B., Peterson E., Tomlanovich M., Early goal-directed therapy in the treatment of severe sepsis and septic shock, N Engl J Med, 345, pp. 1368-1377, (2001)

[4]

Rivers E.P., Ander D.S., Powell D., Central venous oxygen saturation monitoring in the critically ill patient, Curr Opin Crit Care, 7, pp. 204-211, (2001)

[5]

Ladakis C., Myrianthefs P., Karabinis A., Karatzas G., Dosios T., Fildissis G., Gogas J., Baltopoulos G., Central venous and mixed venous oxygen saturation in critically ill patients, Respiration, 68, pp. 279-285, (2001)

[6]

Rady M.Y., Rivers E.P., Martin G.B., Smithline H., Appelton T., Nowak R.M., Continuous central venous oximetry and shock index in the emergency department: Use in the evaluation of clinical shock, Am J Emerg Med, 10, pp. 538-541, (1992)

[7]

Multicentre study on peri- and postoperative central venous oxygen saturation in high-risk surgical patients, Crit Care, 10, (2006)

[8]

Reinhart K., Kuhn H.J., Hartog C., Bredle D.L., Continuous central venous and pulmonary artery oxygen saturation monitoring in the critically ill, Intensive Care Med, 30, pp. 1572-1578, (2004)

[9]

Huber D., Osthaus W.A., Optenhofel J., Breymann T., Marx G., Piepenbrock S., Sumpelmann R., Continuous monitoring of central venous oxygen saturation in neonates and small infants: In vitro evaluation of two different oximetry catheters, Paediatr Anaesth, 16, pp. 1257-1261, (2006)

[10]

Muller M., Lohr T., Scholz S., Thul J., Akinturk H., Hempelmann G., Continuous SvO2 measurement in infants undergoing congenital heart surgery - First clinical experiences with a new fiberoptic probe, Paediatr Anaesth, 17, pp. 51-55, (2007)

← 1 2 3 →