Measurement of Central Venous Oxygen Saturation in Patients with Myocardial Infarction

Goldman, Robert H.; Klughaupt, Martin; Metcalf, Thomas J.; Spivack, Alfred P.; Harrison, Donald C.

doi:10.1161/01.cir.38.5.941

Cited by 93 publications

(22 citation statements)

References 2 publications

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“…Close correlation was found over a wide range of CO in patients with myocardial infarction admitted in a coronary care unit, and ScvO 2 measurement was helpful in assessing the direction of cardiac function and CO changes and monitoring drug therapy [12, 13]. Also, in an experimental study in dogs, Reinhart et al [1]found a high correlation between the two parameters during changes in oxygen supply/demand (r = 0.91–0.97) and that changes in ScvO 2 closely paralleled SvO 2 changes.…”

Section: Discussionmentioning

confidence: 99%

Central Venous and Mixed Venous Oxygen Saturation in Critically Ill Patients

et al. 2001

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Background: Although mixed venous O₂ saturation (SvO₂) accurately indicates the balance of O₂ supply/demand and provides an index of tissue oxygenation, the use of a pulmonary artery (PA) catheter is associated with significant costs, risks and complications. Central venous O₂ saturation (ScvO₂), obtained in a less risky and costly manner, can be an attractive alternative to SvO₂. Objectives: To investigate whether the values of ScvO₂ and SvO₂ are well correlated and interchangeable in the evaluation of critically ill ICU patients and to create an equation that could estimate SvO₂ from ScvO₂. Methods: Sixty-one mechanically ventilated patients were catheterized upon admission and ScvO₂ and SvO₂ values were simultaneously measured in the lower part of the superior vena cava and PA respectively. Results: SvO₂ was 68.6 ± 1.2% (mean ± SEM) and ScvO₂ was 69.4 ± 1.1%. The difference is statistically significant (p < 0.03). The correlation coefficient r is 0.945 for the total population, 0.937 and 0.950 in surgical and medical patients, respectively. In 90.2% of patients the difference was <5%. When regression analysis was performed, among 11 models tested, power model [SvO₂ = b0(ScvO₂)^b1] best described the relationship between the two parameters (R² = 0.917). Conclusions: ScvO₂ and SvO₂ are closely related and are interchangeable for the initial evaluation of critically ill patients even if cardiac indices are different. SvO₂ can be estimated with great accuracy by ScvO₂ in 92% of the patients using a power model.

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Section: Discussionmentioning

confidence: 99%

Central Venous and Mixed Venous Oxygen Saturation in Critically Ill Patients

et al. 2001

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“…In these patients, SvO 2 is tightly correlated with cardiac output and a drop in SvO 2 is a good and early marker of cardiac deterioration [15]. Correlation between SvO 2 and ScvO 2 was insufficient in patients with heart failure [8] but was reported to be accurate in patients with myocardial infarction [21]. Nevertheless, patients with congestive heart failure, who present high serum lactate levels and a low ScvO 2 , require a more aggressive management in the emergency department than patients with normal ScvO 2 and normal lactate levels [22].…”

Section: Severe Trauma and Hemorrhagic Shockmentioning

confidence: 99%

The value of venous oximetry

Reinhart

Bloos

2005

Current Opinion in Critical Care

109

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“…Although studies have established what normal central venous oxygen content is and how it varies in many clinical situations, there appears to be very little corresponding information on peripheral venous oxygen content [89,92,93,95,96]. An elevated peripheral venous oxygen content has been reported in multiple case reports of cyanide poisoning [63,80,82].…”

Section: How High Should Venous Oxygen Content Be To Help Make the DImentioning

confidence: 99%

Case Files from the University of California San Diego Health System Fellowship Coma and Severe Acidosis: Remember to Consider Acetaminophen

Villano

O'Connell

et al. 2015

J. Med. Toxicol.

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A 28-year-old man was brought to the Emergency Department (ED) for evaluation of a depressed level of consciousness that developed while in jail. Sixteen hours previously, he had been arrested on charges of murder. The patient's mental status was reported as normal at the time of arrest, and it had remained so during several hours of interrogation and during the booking process at jail. Following interrogation, the patient was placed into a cell with no other inmates. During the jail intake process, the patient had not reported any history of medical problems nor was he prescribed with any medications. Paramedics arrived to find him unresponsive, but maintaining airway reflexes and hemodynamically stable. They measured a blood glucose of 300 mg/dL and noted one episode of blood-tinged emesis during transport to the ED. No seizure activity was witnessed.On arrival to the ED, vital signs were: heart rate 132/min, blood pressure 129/74 mmHg, temperature 35.3°C (95.5°F), respiratory rate 24/min, and 100 % oxygen saturation on 15 l/ min of oxygen delivered by non-rebreather face mask.Physical examination was notable for a depressed level of consciousness. His eyes remained closed to pain, he withdrew all extremities equally to pain, and he was non-verbal. He had no signs of trauma, and his pupils were normal in size and reactive. Rapid sequence tracheal intubation was performed for airway protection. An electrocardiogram was normal except for sinus tachycardia at a rate of 111/min. An initial peripherally drawn arterial blood gas obtained immediately after intubation revealed: pH 6.97, pCO 2 40 mmHg, pO 2 215 mmHg. A computed tomography scan of the brain was normal. Initial blood chemistry panel was significant for a serum bicarbonate of 7 mEq/L, glucose of 362 mg/dL, and a normal potassium, blood urea nitrogen (BUN), creatinine, and calcium. The initial serum anion gap was 34 mEq/L. Measured serum osmolality was 320 mOsm/kg, yielding an osmol gap of 9 mOsm/kg (using formula of [2(Na)+BUN/2.8+glu-cose/18] for calculated serum osmolarity). Initial lactate was 156.5 mg/dL (normal reference range 4.5-19.8 mg/dL) and beta-hydroxybutyrate (βHB) 2.9 mg/dL (normal reference range 0.0-2.8 mg/dL). Initial liver panel included an aspartate aminotransferase (AST) of 64 U/L, alanine aminotransferase (ALT) of 27 U/L, and bilirubin of 0.4 mg/dL. Prothrombin time was 13.1 s (reference range 9.7-12.5), and lipase was normal at 25 U/L. Initial creatinine phosphokinase (CK) was slightly elevated at 373 U/L (0-175). Urinalysis was positive for small ketones and crystals were not present. Measurements of acetone and acetoacetate were not performed. Serum ethanol and salicylate levels were undetectable, and a urine drug of abuse panel by immunoassay was negative for amphetamines as a class, barbiturates as a class, benzodiazepines as a class, benzoylecgonine (cocaine metabolite), methadone, opiates as class, oxycodone, phencyclidine, and tetrahydrocannabinoids. Iron concentration was normal at 87 mcg/dL.Over the first hour of management,...

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Measurement of Central Venous Oxygen Saturation in Patients with Myocardial Infarction

Cited by 93 publications

References 2 publications

Central Venous and Mixed Venous Oxygen Saturation in Critically Ill Patients

Central Venous and Mixed Venous Oxygen Saturation in Critically Ill Patients

The value of venous oximetry

Case Files from the University of California San Diego Health System Fellowship Coma and Severe Acidosis: Remember to Consider Acetaminophen

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