Rouby J J, Bodin L, Bourgeois J L, Ourhama S, Arthaud M, Viars P
Département d'Anesthésie, Unité de Réanimation Chirurgicale, Hôpital de la Pitié, Paris.
Ann Fr Anesth Reanim. 1989;8(6):672-6. doi: 10.1016/s0750-7658(89)80189-3.
Nineteen intensive care patients with shock and acute respiratory failure were studied using two different fiber-optic catheters used for the continuous measurement of mixed venous blood oxygen saturation (SVO2). In groupe I patients (n = 11), a Swan-Ganz catheter with optic fibres emitting light characterized by three different wavelengths was used (Opticath Oximetrix). In groupe II patients (n = 8), a Sat-one Edwards catheter was used instead (only two different wavelengths). All the patients were studied in the early stages of shock, once all the calibration procedures had been carried out. An increase in FIO2, using PEEP, fluid replacement therapy and vasoactive drugs or diuretics all improved the cardio-respiratory status of each patient. After each new therapeutic procedure, SVO2 was measured in blood samples obtained from these catheters, and from the pulmonary artery (to give the reference value, using an OSM3 Hemoximeter). Over a period of 1.5 to 6 h, 119 measurements were carried out in Group I, and 91 in Group II. The correlation coefficient was higher with the Oximetrix catheter than with the Edwards one (r = 0.970 and 0.855 respectively; p less than 0.001). Moreover, the 24 h spontaneous drift of the former catheter was less than that of the latter (+3.3 +/- 3.1% vs. +9.3 +/- 7%, p less than 0.05). This study showed that a catheter with optic fibres emitting a light with three wavelengths is more accurate than one emitting only two for the measurement of changes in SVO2 in critically ill patients.
对19例患有休克和急性呼吸衰竭的重症监护患者，使用两种不同的用于连续测量混合静脉血氧饱和度（SVO2）的光纤导管进行了研究。在第一组患者（n = 11）中，使用了一种带有发射三种不同波长光的光纤的Swan-Ganz导管（Opticath Oximetrix）。在第二组患者（n = 8）中，改用了Sat-one Edwards导管（仅两种不同波长）。所有患者均在休克早期进行研究，且所有校准程序均已完成。通过增加FIO2、使用呼气末正压通气（PEEP）、液体替代疗法以及血管活性药物或利尿剂，均改善了每位患者的心肺状况。在每次新的治疗程序后，从这些导管以及肺动脉采集血样测量SVO2（使用OSM3血氧计给出参考值）。在1.5至6小时的时间段内，第一组进行了119次测量，第二组进行了91次测量。与Edwards导管相比，Oximetrix导管的相关系数更高（分别为r = 0.970和0.855；p < 0.001）。此外，前一种导管的24小时自发漂移小于后一种导管（+3.3 +/- 3.1% 对 +9.3 +/- 7%，p < 0.05）。这项研究表明，对于危重症患者SVO2变化的测量，发射三种波长光的光纤导管比仅发射两种波长光的导管更准确。
