Continuous SVO2 measurement and oxygen transport patterns in cardiac surgery patients

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Abstract
Twenty adult cardiac surgery patients with impaired ventricular function by contrast ventriculography at cardiac catheterization were monitored from before anesthesia until the time of extubation up to 12 h postoperatively. A thermodilution pulmonary artery catheter with fiberoptic channels for continuous measurement of mixed-venous oxygen saturation (S-vO2) by reflection oximetry was substituted for the usual catheter. The S-vO2 was recorded continuously along with blood pressure, cardiac filling pressures, and heart rate. Thermodilution cardiac output determinations were used to derive hemodynamic and oxygen transport indices. There was a consistently high and significant negative correlation (r = -.84) between S-vO2 and the percentage of oxygen extracted from blood. Thus, S-vO2 reflects oxygen extraction and continuous S-vO2 provides continuous quantification of global oxygen extraction. None of the other oxygen transport variables including cardiac index showed significant correlation with S-vO2. The oximetry system provides a continuous and reliable indication of mixed-venous blood oxygenation which is a continuous reflection of oxygen extraction.

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