[危重症术后患者中心静脉与混合静脉血氧饱和度的比较]

[Comparison of bench central and mixed pulmonary venous oxygen saturation in critically ill postsurgical patients].

作者信息

Pieri M, Brandi L S, Bertolini R, Calafà M, Giunta F

机构信息

Unità di Terapia Intensiva, Università degli Studi, Pisa.

出版信息

Minerva Anestesiol. 1995 Jul-Aug;61(7-8):285-91.

PMID:8948739

Abstract

OBJECTIVE

To investigate if there were differences between bench central oxygen saturation (ScvO2) and mixed venous oxygen saturation (SvO2) in a group of acutely ill postsurgical patients.

DESIGN

A prospective comparative study of two sampling sites.

SETTING

Postsurgical ICU at a University Hospital.

PATIENTS

39 acutely ill postsurgical patients, requiring perioperative invasive hemodynamic monitoring, studied during their stay in a postsurgical ICU.

INTERVENTIONS

Routine care for acutely ill postsurgical patients.

MEASUREMENTS AND MAIN RESULTS

Blood was simultaneously sampled, according to the clinical course, both from the distal and central port of a pulmonary artery catheter (n = 296 each). Oxygen saturation and blood gas analysis were immediately measured with a CO-oxymeter and a blood gas analyzer. We investigated the relationship and the agreement between the two measures. To assess if bench ScVO2 could give information on time related variations of bench SvO2 we evaluated the absolute sequential changes of the two measures during the period of observation, by analyzing the relationship and the agreement of their absolute changes (n = 1817). There was a significant difference between bench SvO2 and bench ScvO2 (71.8 +/- 8.2 vs 72.7 +/- 8.6% mean +/- SD, p < 0.001). The relationship between the two measures showed a significant correlation (r = 0.90, p < 0.001, and SEE 3.8%). The bias was -0.93 +/- 3.8%, and the limits of agreement were +6.6 and -8.5%. The changes in bench ScvO2 correlated with the respective changes in bench SvO2 (r = 0.86, p < 0.001, and SEE 4.4%). The bias was 0.79 +/- 4.7% and the limits of agreement were +9.4 and -7.8%.

CONCLUSIONS

SvO2 cannot be predicted well from bench ScvO2, nor changes in ScO2 can be predicted wel from changes in bench ScvO2. Therefore, in this category of patients, the clinical usefulness of monitoring bench ScvO2 is strongly limited and we must still rely on the SvO2.

摘要

目的

调查一组急性病术后患者的床边中心静脉血氧饱和度（ScvO2）与混合静脉血氧饱和度（SvO2）之间是否存在差异。

设计

对两个采样部位进行前瞻性比较研究。

地点

大学医院的术后重症监护病房。

患者

39例急性病术后患者，需要围手术期有创血流动力学监测，在其入住术后重症监护病房期间进行研究。

干预措施

对急性病术后患者的常规护理。

测量和主要结果

根据临床病程，同时从肺动脉导管的远端和中心端口采集血液（各296次）。立即用一氧化碳血氧仪和血气分析仪测量血氧饱和度和血气分析。我们研究了这两种测量方法之间的关系和一致性。为了评估床边ScVO2是否能提供有关床边SvO2时间相关变化的信息，我们通过分析两种测量方法绝对变化的关系和一致性，评估了观察期内两种测量方法的绝对顺序变化（n = 1817）。床边SvO2与床边ScvO2之间存在显著差异（平均±标准差分别为71.8±8.2%和72.7±8.6%，p < 0.001）。两种测量方法之间的关系显示出显著相关性（r = 0.90，p < 0.001，标准误3.8%）。偏差为-0.93±3.8%，一致性界限为+6.6%和-8.5%。床边ScvO2的变化与床边SvO2的相应变化相关（r = 0.86，p < 0.001，标准误4.4%）。偏差为0.79±4.7%，一致性界限为+9.4%和-7.8%。