Davies G G, Mendenhall J, Symreng T
Department of Anesthesia, University of Iowa College of Medicine, Iowa City 52242.
J Clin Monit. 1988 Apr;4(2):99-102. doi: 10.1007/BF01641809.
Continuous fiberoptic measurement of mixed venous oxygen saturation (SvO2) via a pulmonary artery catheter is a useful, though invasive, monitoring technique. Continuous right atrial venous oxygen saturation measurement by oximetry offers the potential of a significantly less invasive SvO2 measurement. However, catheter motion, character of the vessel, chamber wall reflection, the filtering technique involved in calculating oxygen saturation, and the streaming of venous blood prior to ventricular mixing may influence the feasibility of continuous right atrial (RA) SvO2 measurement. This study investigated the performance of fiberoptically measured RA SvO2, at a position 2 cm from the tricuspid valve, relative to simultaneously measured pulmonary artery (PA) SvO2. Ten pigs were subjected to circulatory shock or chemically induced lung damage. Over a total monitoring period of approximately 40 hours, 464 paired data points were sampled at 5-minute intervals. The difference between the overall means of RA and PA SvO2 was 0.91% with a standard error of the estimate of 4.7%, a regression equation of RA SvO2 = PA SvO2 (0.94 + 2.1) PA So2, and a correlation coefficient of 0.94. Our conclusion, although extrapolated from a pig model, is that fiberoptic SvO2 monitoring may be accomplished less invasively and at a lower cost with a right atrial catheter.
通过肺动脉导管连续光纤测量混合静脉血氧饱和度(SvO2)是一种有用的监测技术,尽管具有侵入性。通过血氧测定法连续测量右心房静脉血氧饱和度为侵入性显著更低的SvO2测量提供了可能。然而,导管移动、血管特性、腔壁反射、计算血氧饱和度所涉及的滤波技术以及心室混合前静脉血的流动可能会影响连续测量右心房(RA)SvO2的可行性。本研究调查了在距三尖瓣2 cm处通过光纤测量的RA SvO2相对于同时测量的肺动脉(PA)SvO2的性能。对10头猪进行循环休克或化学诱导的肺损伤。在总共约40小时的监测期内,每隔5分钟采集464对数据点。RA和PA SvO2总体均值之间的差异为0.91%,估计标准误差为4.7%,RA SvO2的回归方程为RA SvO2 = PA SvO2(0.94 + 2.1)PA So2,相关系数为0.94。我们的结论是,尽管是从猪模型推断而来,但通过右心房导管进行光纤SvO2监测可以以侵入性更小且成本更低的方式完成。