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中心静脉血氧饱和度与混合静脉血氧饱和度:犬开胸心肺复苏期间的比较

Central venous and mixed venous oxygen saturation: comparison during canine open-chest cardiopulmonary resuscitation.

作者信息

Martin G B, Carden D L, Nowak R M, Tomlanovich M C

出版信息

Am J Emerg Med. 1985 Nov;3(6):495-7. doi: 10.1016/0735-6757(85)90158-5.

Abstract

Mixed venous oxygen saturation (MVO2) is a valuable parameter in monitoring critically ill patients because it serves as an index of the adequacy of the oxygen delivery system. Mixed venous oxygen saturation as reflected by the easily obtainable central venous oxygen saturation (CVO2) may prove useful during cardiopulmonary resuscitation (CPR) as an indicator of both the adequacy of varying CPR regimens and the efficacy of pharmacological interventions. This study investigates the relationship between CVO2 and MVO2 and its clinical usefulness during CPR. Swan-Ganz and central venous catheters were placed in 20 mongrel dogs. Ventricular fibrillation was then induced and, after predetermined downtimes ranging from 5 to 60 minutes, thoracotomy was performed, and open-chest bimanual cardiac massage was started. Central venous and mixed venous blood-gas samples were drawn every five minutes during a 30-minute period of CPR. The correlation between CVO2 and MVO2 was 0.8719 (P less than 0.001) before arrest but deteriorated at all times during CPR with values ranging from 0.1589 (P = 0.542) to 0.5781 (P = 0.024). Although statistically significant at times, the correlation between CVO2 and MVO2 during CPR is not consistently high enough to enable the routine substitution of CVO2 for MVO2 in assessing the oxygen delivery system.

摘要

混合静脉血氧饱和度(MVO2)是监测危重症患者的一个重要参数,因为它可作为氧输送系统是否充足的一个指标。由易于获取的中心静脉血氧饱和度(CVO2)所反映的混合静脉血氧饱和度,在心肺复苏(CPR)期间可能作为不同CPR方案是否充足以及药物干预效果的一个指标而有用。本研究调查了CVO2与MVO2之间的关系及其在CPR期间的临床实用性。将Swan-Ganz导管和中心静脉导管置入20只杂种犬体内。然后诱发心室颤动,在5至60分钟的预定停搏时间后,进行开胸手术,并开始开胸双手心脏按压。在30分钟的CPR期间,每5分钟采集一次中心静脉和混合静脉血样。心脏停搏前CVO2与MVO2的相关性为0.8719(P<0.001),但在CPR期间各时段均变差,值范围为0.1589(P=0.542)至0.5781(P=0.024)。尽管在某些时候具有统计学意义,但CPR期间CVO2与MVO2之间的相关性并非始终足够高,无法在评估氧输送系统时常规用CVO2替代MVO2。

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