Central venous saturation is not an alternative to mixed venous saturation during cardiopulmonary bypass in coronary artery surgery patients

Perfusion. 2012 Jul;27(4):300-6. doi: 10.1177/0267659112442902. Epub 2012 Apr 12.

Abstract

Background: To evaluate the correlation and agreement between central venous saturation (ScvO(2)) and mixed venous saturation (SvO(2)) during cardiopulmonary bypass.

Methods: Twenty-two consecutive patients scheduled for coronary artery surgery were prospectively included. Paired measurements of ScvO(2) and SvO(2) were performed 5 minutes after aortic cross-clamping, after each cardioplegia dose and after de-clamping of the aortic cross-clamp. ScvO(2) and SvO(2) were measured, respectively, by a fibreoptic catheter in the superior vena cava and on blood samples from the venous return line of the extracorporeal circuit, using a blood gas analyser

Results: Ninety-five paired measurements of venous saturation were obtained. Correlation between the measurements was associated with an r = 0.55. The mean bias was 2.2 [Limits of agreement: -13.6%, +18%]. Changes in oxygen saturation over time showed an r = 0.4 and a mean bias of 0.2 [Limits of agreement: -17.9%, +18.3%]. Multivariate analysis identified the oxygen consumption index as the only factor explaining this variability.

Conclusions: Although mean biases between the measurements were low, limits of agreement were too large to provide a clinically acceptable estimation of SvO(2) by ScvO(2) in these conditions. Variations in regional oxygen consumption seem to be the main factor worsening the relationship.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Aged
  • Cardioplegic Solutions / administration & dosage
  • Cardiopulmonary Bypass*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oximetry / methods*
  • Oxygen / blood*
  • Oxygen Consumption*

Substances

  • Cardioplegic Solutions
  • Oxygen