| Autor: |
Sander, Michael, Spies, Claudia D., Foer, Achim, Weymann, Lisa, Braun, Jan, Volk, Thomas, Grubitzsch, Herko, Heymann, Christian von, von Heymann, Christian |
| Předmět: |
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| Zdroj: |
Intensive Care Medicine; Oct2007, Vol. 33 Issue 10, p1719-1725, 7p, 3 Charts, 3 Graphs |
| Abstrakt: |
Comparison of the bias and the limits of agreement (LOA; 2 SD) of the central venous saturation (ScvO2) before, during and after coronary artery bypass graft surgery with a simultaneous measurement of the mixed venous saturation (SvO2). Prospective controlled study in a university hospital department of anaesthesiology. 60 patients with coronary artery bypass surgery, 300 paired measurements of SvO2 and ScvO2. ScvO2 and SvO2 were analysed after induction of anaesthesia 15 min after cardiopulmonary bypass and 1, 6 and 18 h after admission to the intensive care unit. Regression analysis for the pooled measurements of ScvO2 and SvO2 showed a correlation R 2 = 0.52. After induction of anaesthesia 15 min after weaning from cardiopulmonary bypass and 6 h after admission to the intensive care unit the correlation coefficient was R 2 = 0.46, on admission to the intensive care unit it was R 2 = 0.42, and at 18 h it was R 2 = 0.38. Bland–Altman analysis for the measurements of ScvO2 and SvO2 showed a mean bias and LOA of 0.3% and −11.9 to +12.4%. In patients with a low ScvO2 there was a trend to overestimate the SvO2 by using the ScvO2. The only factor that influenced the ΔSvO2 − ScvO2 was the oxygen extraction rate ( R 2 = 0.16). In patients with ScvO2 below 70% this association was more pronounced ( R 2 = 0.60). Our findings demonstrate that oxygen extraction rate is the major factor in the difference between SvO2 and ScvO2. Under certain circumstances ScvO2 differed substantially from SvO2. Therefore in selected patients both parameters should be monitored to exclude general or focal hypoperfusion. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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