Clinical evaluation of continuous monitoring of mixed venous oxygen saturation in critically ill patients

Aishima, K.; Takahashi, S.; Yoshitake, J.

Fukuoka Igaku Zasshi 75(7): 445-452


ISSN/ISBN: 0016-254X
PMID: 6500478
Accession: 004968158

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It is generally recognized that the changes of mixed venous blood O2 saturation (S.hivin.vO2) may reflect variable factors, for example cardiac output, the changes of A-a DO [alveolar to arterial diffusing capacity for O2] tissue perfusion and O2 consumption. The new pulmonary arterial flow-directed catheter (OPTICATH) combined the standard pulmonary artery catheter and a fiberoptic photometric system for continuous display of S.hivin.vO2 was studied in 12 patients undergoing cardiovascular surgery. Six cases were ASA status III and 5 cases were status IV. The relationship between mixed venous blood O2 saturation or content (C.hivin.VO2) and cardiac output can be exhibited by the Fick Formula. In the cases of only cardiac dysfunction, the changes of S.hivin.VO2 and cardiac index adjust each other. In the critically ill cases there is not a good correlation between the S.hivin.VO2 and the cardiac index. In the cases of increased A-a DO2, such as pulmonary edema, the value of S.hivin.vO2 is decreased by the low PaO2 [arterial O2 partial pressure] and there is a poor correlation between the S.hivin.vO2 and the cardiac index. This new fiberoptic photometric system has a high degree of accuracy and a rapid response time. Continuous monitoring of S.hivin.vO2 is valuable as a warning system for deterioration in cardiopulmonary function and as an indicator of the effects of various therapeutic management in critically ill patients.