Department of Anesthesiology and Critical Care Medicine, The George Washington University Medical Center, Washington, DC 20037, USA.
Chest. 2010 Jul;138(1):76-83. doi: 10.1378/chest.09-2680. Epub 2010 Apr 23.
Central venous oxygen saturation (Scv(O(2))) has been used as a surrogate marker for mixed venous oxygen saturation (Sv(O(2))). Femoral venous oxygen saturation (Sfv(O(2))) is sometimes used as a substitute for Scv(O(2)). The purpose of this study is to test the hypothesis that these values can be used interchangeably in a population of patients who are critically ill.
We conducted a survey to assess the frequency of femoral line insertion during the initial treatment of patients who are critically ill. Scv(O(2)) vs Sfv(O(2)) STUDY: Patients with femoral and nonfemoral central venous catheters (CVCs) were included in this prospective study. Two sets of paired blood samples were drawn simultaneously from the femoral and nonfemoral CVCs. Blood samples were analyzed for oxygen saturation and lactate.
One hundred and fifty physicians responded to the survey. More than one-third of the physicians insert a femoral line at least 10% of the time during the initial treatment of patients who were critically ill. Scv(O(2)) vs Sfv(O(2)) STUDY: Thirty-nine patients were enrolled. The mean Scv(O(2)) and Sfv(O(2)) were 73.1% +/- 11.6% and 69.1% +/- 12.9%, respectively (P = .002), with a mean bias of 4.0% +/- 11.2% (95% limits of agreement: -18.4% to 26.4%). The mean serum lactate from the nonfemoral and femoral CVCs was 2.84 +/- 4.0 and 2.72 +/- 3.2, respectively (P = .15).
This study revealed a significant difference between paired samples of Scv(O(2)) and Sfv(O(2)). More than 50% of Scv(O(2)) and Sfv(O(2)) values diverged by > 5%. Sfv(O(2)) is not always a reliable substitute for Scv(O(2)) and should not routinely be used in protocols to help guide resuscitation.
中心静脉血氧饱和度（Scv(O(2))) 已被用作混合静脉血氧饱和度（Sv(O(2))) 的替代标志物。股静脉血氧饱和度（Sfv(O(2))) 有时被用作 Scv(O(2))) 的替代物。本研究的目的是检验这样一个假设，即在危重病患者人群中，这些值可以互换使用。
我们进行了一项调查，以评估在危重病患者初始治疗期间插入股静脉置管的频率。Scv(O(2)) 与 Sfv(O(2))) 研究：本前瞻性研究纳入了有股静脉和非股静脉中心静脉导管（CVC）的患者。同时从股静脉和非股静脉 CVC 中抽取两组配对血样。对血样进行氧饱和度和乳酸分析。
150 名医生对调查做出了回应。超过三分之一的医生在危重病患者的初始治疗中至少有 10%的时间插入股静脉置管。Scv(O(2)) 与 Sfv(O(2))) 研究：共纳入 39 名患者。Scv(O(2)) 和 Sfv(O(2))) 的平均值分别为 73.1% +/- 11.6% 和 69.1% +/- 12.9%（P =.002），平均偏差为 4.0% +/- 11.2%（95% 一致性界限：-18.4% 至 26.4%）。非股静脉和股静脉 CVC 的血清乳酸平均值分别为 2.84 +/- 4.0 和 2.72 +/- 3.2（P =.15）。
本研究揭示了 Scv(O(2))) 和 Sfv(O(2))) 配对样本之间存在显著差异。超过 50%的 Scv(O(2))) 和 Sfv(O(2))) 值相差>5%。Sfv(O(2))) 并不总是 Scv(O(2))) 的可靠替代物，不应在指导复苏的方案中常规使用。
