Mixed venous versus central venous oxygen saturation in patients undergoing on pump beating coronary artery bypass grafting

接受泵跳动冠状动脉搭桥术患者的混合静脉与中心静脉血氧饱和度

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作者:Ahmad Alshaer, Mohamed Essam Abdel-Meguid, Osama Ibraheim, Khaled Fawzi, Ibrahim Abdulsalam, Saad Sheta, Khaled M Abdullah, Ahmed El-Demerdash, Raed Al-Satli, Mohamed Abdelall, Bakir M Bakir, Nezar Alnahal, Yasser Abdulrahman, Hanaa Alhamoud

Conclusions

In on pump beating CABG patients; ScvO(2) and SvO(2) are not interchangeable numerically. ScvO(2) is useful in the meaning of trend; our data suggest that ScvO(2) is equivalent to SvO(2) , only in the course of clinical decisions as long as absolute values are not required.

Methods

Prospective clinical observational study was done at King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. Thirty four adult patients scheduled for coronary artery surgery were included. Patients were monitored by a pulmonary artery catheter (PAC) as a part of our routine intraoperative monitoring. SvO(2) and ScvO(2) were simultaneously measured 15 minutes (T1) and 30 minutes (T2) after induction of anesthesia, 15 and 30 minutes after initiation of cardiopulmonary bypass (T3 and T4), and 15 and 30 minutes after admission to intensive care unit (T5 and T6).

Objective

To examine the validity of central venous oxygen saturation (ScvO(2)) as a numerical substitution of mixed venous oxygen saturation (SvO(2)) in adult patients undergoing normothermic on pump beating coronary artery bypass grafting (CABG). Materials and

Results

ScvO(2) showed higher reading than SvO(2) all through our study. Our results showed perfect positive statistically significant correlation between SvO(2) and ScvO(2) at all data points. Individual mean of difference (MOD) between both the readings at study time showed MOD of 1.34 and 1.44 at T1 and T2 simultaneously. This MOD was statistically insignificant, but after on pump beating normothermic bypass was initiated; MOD was 5.2 and 4.4 at T3 and T4 with high statistical significance. In ICU, MOD continues to have high statistical significance, MOD was 6.3 at T5 and at T6 it was 4.6. Conclusions: In on pump beating CABG patients; ScvO(2) and SvO(2) are not interchangeable numerically. ScvO(2) is useful in the meaning of trend; our data suggest that ScvO(2) is equivalent to SvO(2) , only in the course of clinical decisions as long as absolute values are not required.

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