Blasco V, Leone M, Textoris J, Visintini P, Albanèse J, Martin C
Département d'anesthésie et de réanimation, faculté de médecine de Marseille, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
Ann Fr Anesth Reanim. 2008 Jan;27(1):74-82. doi: 10.1016/j.annfar.2007.10.031.
The aims of this review are to point out the determinants of oxygen saturation of the haemoglobin of mixed venous blood (SvO(2)), to specify the correlations existing between SvO(2) and central venous saturation in superior vena cava (ScvO(2)), to determine and finally to locate the current place of venous oximetry in clinical practice.
A PubMed database research in English and French languages published until December 2006. The keywords were mixed venous blood oxygen saturation; oxygen consumption; oxygen delivery; oxygen extraction; tissue hypoxia; central venous oxygen saturation.
Data in selected articles were reviewed, clinical and basic science research relevant information was extracted.
The SvO(2) reflects the peripheral extraction of oxygen (O(2)), O(2) delivery and consumption. Its value is related to four determinants: the O(2) consumption (VO(2)), cardiac flow (CF), haemoglobin level (Hb) and O(2) saturation of the haemoglobin of arterial blood (SaO(2)). ScvO(2) is more easily measurable than SvO(2). Under physiological conditions its value is 2 to 3% lower than that of SvO(2). In the critically ill patient, its value is 5% higher than that SvO(2). In most patients, changes in ScvO(2) values parallel those in SvO(2). The clinical interest of the monitoring of venous oximetry was underlined in cases of severe sepsis and septic shock, and during the perioperative period of major surgery.
The management of patients in critical states with therapeutic goals integrating the monitoring of venous oximetry may reduce the morbidity and mortality of patients undergoing major surgery or hospitalised in the intensive care unit.
本综述旨在指出混合静脉血血红蛋白氧饱和度（SvO₂）的决定因素，明确SvO₂与上腔静脉中心静脉血氧饱和度（ScvO₂）之间存在的相关性，确定并最终明确静脉血氧饱和度测定法在临床实践中的当前地位。
对截至2006年12月以英文和法文发表的PubMed数据库进行检索。关键词为混合静脉血氧饱和度；氧消耗；氧输送；氧摄取；组织缺氧；中心静脉血氧饱和度。
对所选文章中的数据进行综述，提取临床和基础科学研究的相关信息。
SvO₂反映外周氧摄取（O₂）、O₂输送和消耗情况。其值与四个决定因素有关：氧消耗（VO₂）、心输出量（CF）、血红蛋白水平（Hb）和动脉血血红蛋白氧饱和度（SaO₂）。ScvO₂比SvO₂更容易测量。在生理条件下，其值比SvO₂低2%至3%。在危重病患者中，其值比SvO₂高5%。在大多数患者中，ScvO₂值的变化与SvO₂值的变化平行。在严重脓毒症和脓毒性休克病例以及大手术围手术期，强调了监测静脉血氧饱和度测定法的临床意义。
以整合静脉血氧饱和度监测的治疗目标对危重症患者进行管理，可能会降低接受大手术患者或入住重症监护病房患者的发病率和死亡率。
