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Mixed Venous Oxygen Saturation Measured with an Abbot Oximetric Pulmonary Artery Catheter, and Instrumentation Laboratory Co-Oximeter after Resuscitation with Varying Concentrations of Hemoglobin-Based Oxygen Carrier in a Dog Hemorrhage Model



Mixed Venous Oxygen Saturation Measured with an Abbot Oximetric Pulmonary Artery Catheter, and Instrumentation Laboratory Co-Oximeter after Resuscitation with Varying Concentrations of Hemoglobin-Based Oxygen Carrier in a Dog Hemorrhage Model



Anesthesiology Abstracts of Scientific Papers Annual Meeting (2001): Abstract No. A-556



INTRODUCTION:Hemoglobin-based oxygen carriers (HBOC) have been documented to alter SO2 measurements (1). We compared SvO2 values from the oximetric pulmonary artery catheter (Add catheter information, Q2 System, Abbott Laboratories, Chicago, IL) and co-oximeter (482 Co-Oximeter System, Instrumentation Laboratory, Lexington, MA) with calculated values from oxygen content (2). METHODS:In 17 anesthetized, splenectomized mixed breed dogs of both genders, pulmonary artery was canulated through jugular vein. The position of the catheter was documented by obtaining consistent pulmonary artery occlusion pressures. Blood samples from the distal port were slowly and anaerobically collected at four time points: baseline, one hour after completion of 30-minute hemorrhage (about 40% of circulating blood volume, to keep mean arterial blood pressure at 50 mm Hg (3), immediately, and then 3 hours after resuscitation using either 30 ml/kg 6% hetastarch (Hextend (R), Abbott Laboratories, Chicago, IL), or 10, or 20 ml/kg Hemoglobin-glutamer-200 (bovine)(Biopure, Cambridge,MA) with 20 or 10 ml/kg 6% hetastarch respectively. Samples were immediately evaluated on the co-oximeter and LEXO2CON-K (Hospex Fiberoptics, Chestnut Hill, MA) in triplicates and averaged. Oxygen saturations from the oximetric pulmonary artery catheter were obtained continuously during experiments, and recorded at the time of the blood samplings. Based on the measurements obtained with the investigated instruments, oxygen content (Co2) was calculated for each sample using adjusted for canine hemoglobin and HBOC equation (2): Co2 = (SO2) x (1.32 bHb + 1.39cHb) = pO2 x 0.003, where SO2 - hemoglobin oxygen saturation, bHb - HBOC (bovine hemoglobin) concentration, cHb - canine hemoglobin concentration. The constants 1.32 and 1.39 represent the theoretical oxygen capacities of 1 g of bovine and canine hemoglobin calculated by molecular weight (68,000 and 64,458 Dalton, respectively). Results were compared with the oxygen content from the LEXO2CON-K. (Statistical analysis was performed using SPSS 10.1 software with significance level set at 0.05. RESULTS:At the baseline, the calculated from oxygen content values of oxygen saturation were well correlated with values from co-oximeter and catheter (r=0.74). One hour after resuscitation, the correlation was even higher after infusion of 30 ml/kg of hetastarch (r=0.96 with catheter, and r=0.95 with co-oximeter). After infusion of 10 mg/kg of HBOC and 20 mg/kg of hetastarch, the correlation between values from the catheter, co-oximeter and calculated values was slightly lower (r=0.76 and r=0.87). When 20 ml/kg of HBOC and 10 mg/kg of Hetastarch were infused, the correlation between calculated and measured values were low (r=0.43 for the catheter, and r=0.59 for the co-oximeter). Three hours after resuscitation, the correlation between both measurements and calculated values were high in all groups. The difference between calculated and measured values of oxygen saturation demonstrated low, but statisticaly significant c! orrelation with concentration of HBOC (r=0.36, p=0.002 for the catheter, r=-0.33, p=0.007 for co-oximeter). CONCLUSION: The presence of HBOC in the blood can alter the accuracy of oxygen saturation measurements in mixed venous blood with the co-oximeter and oximetric pulmonary artery catheter.

Accession: 035317847

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