Continuous monitoring of central venous oxygen saturation (Pediasat) in pediatric patients undergoing cardiac surgery: a validation study of a new technology.

OBJECTIVE

Mixed venous oxygen saturation and central venous oxygen saturation are considered possible indicators of the adequacy of oxygen delivery with respect to the oxygen needs of critically ill adult and pediatric patients. The present study was aimed at validating the accuracy of a new technology (Pediasat central venous catheter) in providing a continuous measurement of the central venous oxygen saturation in pediatric patients.

DESIGN

A prospective observational study.

PARTICIPANTS

Thirty pediatric patients (age, 6 days-9 years) undergoing cardiac operations. Data obtained with the Pediasat during and after the operation were compared with simultaneously collected venous blood samples analyzed with standard laboratory techniques.

SETTING

A clinical research hospital.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

A Bland and Altman analysis was performed on 30 matched sets of data collected before cardiopulmonary bypass, during cardiopulmonary bypass, and during the intensive care unit stay. Before cardiopulmonary bypass, there was a bias of 0.003, with lower and upper limits of agreement, -5.84 and 5.84 (percentage error, 17.3%). During cardiopulmonary bypass, the bias was 0.57 and lower and upper limits of agreement were -7.7 and 8.7 (percentage error, 23.2%). At 2 hours after the arrival in the intensive care unit, the bias was -0.6 and the lower and upper limits of agreement were -8 and 6.8 (percentage error, 20.3%).

CONCLUSIONS

Because of the minimal bias and the acceptable value of percentage error, the Pediasat may be considered as an accurate tool for the continuous measurement of the central venous oxygen saturation in neonates and pediatric patients during and after cardiac operations.