Diagnostic accuracy of central venous saturation in estimating mixed venous saturation is proportional to cardiac performance among cardiac surgical patients

Gašparović, Hrvoje and Gabelica, Rajka and Ostojić, Zvonimir and Kopjar, Tomislav and Petričević, Mate and Ivančan, Višnja and Biočina, Bojan (2014) Diagnostic accuracy of central venous saturation in estimating mixed venous saturation is proportional to cardiac performance among cardiac surgical patients. Journal of Critical Care, 29 (5). pp. 828-834. ISSN 0883-9441

PDF - Accepted Version
Download (354kB) | Preview


PURPOSE: Advanced hemodynamic monitoring in cardiac surgery translates into improvement in outcomes. We evaluated the relationship between central venous (ScvO2) and mixed venous (SvO2) saturations over the early postoperative period. The adequacy of their interchangeability was tested in patients with varying degrees of cardiac performance. ----- METHODS: In this prospective observational study, we evaluated 156 consecutive cardiac surgical patients in an academic center. The ScvO2 and SvO2 data were harvested from 468 paired samples taken preoperatively (T0), after weaning from cardiopulmonary bypass (T1) and on postoperative day 1 (T2). ----- RESULTS: The relationship between ScvO2 and SvO2 was inconsistent, with inferior correlations in patients with lower cardiac indices (CI) (Pearson r(2) = 0.37 if CI ≤2.0 L/min per square meter vs r(2) = 0.73 if CI >2.0 L/min per square meter, both P < .01). Patients with lower CI also had wider 95% limits of agreement between SvO2 and ScvO2. The proportion of patients with a negative SvO2-ScvO2 gradient increased over time (48/156 [31%] at T0 to 73/156 [47%] at T2; P < .01). This subgroup more frequently required inotropes at T2 than patients with a positive SvO2-ScvO2 gradient (odds ratio, 6.46 [95% confidence interval, 0.81-51.87], P = .06) and also had higher serum lactate levels (1.5 ± 0.8 vs 1.0 ± 0.4; P < .01). ----- CONCLUSIONS: The diagnostic accuracy of ScvO2 for estimating SvO2 is proportional to cardiac performance. A negative SvO2-ScvO2 gradient at T2 correlated with inotropic support requirement, higher operative risk score, age, lactate level, and duration of cardiopulmonary bypass.

Item Type: Article
MeSH: Adult ; Aged ; Cardiac Output, Low/blood ; Cardiac Output, Low/physiopathology ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Catheterization, Swan-Ganz/methods ; Catheterization, Swan-Ganz/standards ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic/methods ; Oxygen/blood ; Postoperative Period ; Prospective Studies ; Reproducibility of Results ; Thermodilution/methods
Departments: Katedra za kirurgiju
Depositing User: Marijan Šember
Status: Published
Gašparović, HrvojeUNSPECIFIED
Gabelica, RajkaUNSPECIFIED
Ostojić, ZvonimirUNSPECIFIED
Kopjar, TomislavUNSPECIFIED
Petričević, MateUNSPECIFIED
Ivančan, VišnjaUNSPECIFIED
Date: October 2014
Date Deposited: 16 Sep 2015 11:02
Last Modified: 16 Jul 2020 09:44
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2264

Actions (login required)

View Item View Item


Downloads per month over past year