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机械通气冠状动脉搭桥术患者混合静脉血氧饱和度与心输出量的关系。

The relationship between mixed venous oxygen saturation and cardiac output in mechanically ventilated coronary artery bypass graft patients.

作者信息

Noll M L, Fountain R L

出版信息

Prog Cardiovasc Nurs. 1990 Jan-Mar;5(1):34-40.

PMID:2367516
Abstract

This study examined the relationship between mixed venous oxygen saturation (SvO2) and cardiac output (CO) in coronary artery bypass graft (CABG) surgery patients, age 35 to 70 years, who were 6.0 to 9.5 hours postoperative, hemodynamically stable, and receiving mechanical ventilation. A total of five paired measurements of SvO2 and thermodilution CO's were recorded on 30 subjects during a 45 minute time period. Correlations between SvO2 and CO for the entire sample ranged from 0.27 (NS*) to 0.45 (p less than or equal to 0.01). Additional analysis was done to determine if continuous infusions of vasoactive drugs influenced the relationship between the variables. Correlations for those on continuous vasoactive medications ranged from 0.21 to 0.31 (NS). Correlations for subjects who did not require vasoactive infusions were higher, ranging from 0.53 (NS) to 0.81 (p less than or equal to .01). Although many results were statistically significant, correlations less than 0.7 should not be used for clinical decision making. SvO2 reflects the overall tissue oxygenation and should not be used as a substitute for CO measurements in the CABG patient in the early hours after cardiac surgery.

摘要

本研究调查了年龄在35至70岁之间、术后6.0至9.5小时、血流动力学稳定且接受机械通气的冠状动脉旁路移植术(CABG)患者的混合静脉血氧饱和度(SvO2)与心输出量(CO)之间的关系。在45分钟内,对30名受试者进行了总共五次SvO2和热稀释法测量CO的配对测量。整个样本中SvO2与CO之间的相关性范围为0.27(无显著性差异*)至0.45(p≤0.01)。进行了额外分析以确定持续输注血管活性药物是否会影响这些变量之间的关系。持续使用血管活性药物的受试者的相关性范围为0.21至0.31(无显著性差异)。不需要血管活性药物输注的受试者的相关性更高,范围为0.53(无显著性差异)至0.81(p≤0.01)。尽管许多结果具有统计学显著性,但相关性小于0.7不应作为临床决策的依据。SvO2反映了整体组织氧合情况,在心脏手术后早期,不应将其用作CABG患者CO测量的替代指标。

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