Reliability of the special calculations of oxygenation from central venous samples in cardiac surgery
Keywords:
axygen saturation, arterio-venous oxygen dyfferences, mixed venous and central venous, shuntAbstract
Introduction and Objectives: Different mechanisms are involved in the uptake, transportation, delivery and utilization of oxygen in living organisms, and each of them may be affected in the severely ill patient. The purpose of this study was to determine the reliability of the special calculations of oxygenation, from central venous samples. Methods: A prospective study was performed on 22 patients who underwent cardiac surgery, and in which special calculations obtained from central venous samples were compared to mixed-venous samples calculations. Results: A statistically significant correlation among the arteriovenous oxygen difference, the shunt and the venous hemoglobin oxygen saturation was found. However, a small percentage of reliability was found when subjected to the standardized criteria, but through regression equations, it was possible to achieve a highly significant correction (p < 0,01), which increased the reliability by over 90%. Conclusions: The central venous sampling is an alternative recommended for special calculations of oxygenation during cardiac surgery.
Downloads
References
1. Santos LA. Insuficiencia respiratoria aguda. En: Caballero A, Bequer E, Santos LA, Domínguez M, López M y cols: Terapia Intensiva. 2da. ed. Santa Clara: Ciencias Médicas; 2000. p. 1877-2002.
2. Scope DR. Cálculo del contenido de oxígeno; 2005. [Consultado: 13 de Octubre de 2007]. Disponible en:
http://www.drscope.com/pac/anestesia-1/b1/an1b1_p25.htm
3. Pajón MJ, Fernández de la Reguera G, Hurtado IC, Molina FJ, Blackaller R, Luna P. Complicaciones del uso del catéter de flotación pulmonar en cirugía cardiovascular: estudio prospectivo. Arch Inst Cardiol Méx. 1986;56(2):147-55.
4. Díaz-Alersi R. El Swan-Ganz en el año 2000. En: Congreso Internacional de Medicina Crítica CIMC 2000. España; 2000. Disponible en:
http://www.uninet.edu/cimc2000/conferencia/conf24/Ramon.htm
5. Burns J, Sing R, Mostafa G, Huynh T, Jacobs D, Miles W, et al. The role of transesophageal echocardiography in optimizing resuscitation in acutely injured patients. J Trauma. 2005;59(1):36-40.
6. Díaz-Alersi R. La tecnología y sus peligros. Electron J Biomed .2005;3:2-4.
7. López MS, Areu AJ. Shock ¿Qué hay de nuevo? Rev Cubana Cir. 2003;42(1):14-7.
8. UNInet. Shock. En: Principios de Urgencias, Emergencias y Cuidados Críticos. 2006. Disponible en:
http://tratado.uninet.edu/c010201.html
9. Agostoni P, Salvioni E, Debenedetti C, Vignati C, Cattadori G, Contini M, et al. Relationship of resting hemoglobin concentration to peak oxygen uptake in heart failure patients. Am J Hematol. 2010 Jun;85(6):414-7.
10. Álvarez J, Bouzada M, Fernández AL, Caruezo V, Taboada M, Rodríguez J, et al. Comparación de los efectos hemodinámicos del levosimendán con la dobutamina en pacientes con bajo gasto después de cirugía cardíaca. Rev Esp Cardiol. 2006;59(4):338-45.
11. Ho KM, Harding R, Chamberlain J, Bulsara M. A comparison of central and mixed venous oxygen saturation in circulatory failure. J Cardiothorac Vasc Anesth. 2010 Jun;24(3):434-9.
12. Scope DR. Transporte de oxígeno; 2005. [Consultado: 13 de Octubre de 2007]. Disponible en: http://www.drscope.com/pac/anestesia-1/b1/an1b1_p24.htm
13. Cancela M. El posoperatorio de cirugía cardíaca en la unidad de medicina intensiva. En: Artucio H, Reppi G, Cancela M, Garrido R, Hurtado J, Lluberas R y cols. Medicina Intensiva Cardiovascular. Montevideo: Colección CTI Universitario; 2001. p. 383-408.
14. Garrido R. Monitoreo hemodinámico. En: Artucio H, Reppi G, Cancela M, Garrido R, Hurtado J, Lluberas R y cols. Medicina Intensiva Cardiovascular. Montevideo: Colección CTI Universitario; 2001. p. 53-108.
15. Fuentes L. Shock. En: Álvarez G, Martínez JF, Cuadrado R, Martín L, Rodríguez G, García R, et al. Temas de guardia médica. Santa Clara: Ciencias Médicas; 2003. p. 64-79.
16. Rivers E. Mixed vs central venous oxygen saturation may be not numerically equal, but both are still clinically useful. Chest. 2006 Mar;129(3):507-8.
17. el-Masry A, Mukhtar AM, el-Sherbeny AM, Fathy M, el-Meteini M. Comparison of central venous oxygen saturation and mixed venous oxygen saturation during liver transplantation. Anaesthesia. 2009 Apr;64(4):378-82.
18. Barrat-Boyes BG, Wood EH. Oxygen saturation of blood in the venae cavae, right heart chambers, and pulmonary vessels of healthy subjets. J Lab Clin Med. 1957; 50:93-106.
19. Maddirala S, Khan A. Optimizing hemodynamic support in septic shock using central and mixed venous oxygen saturation. Crit Care Clin. 2010 Apr;26(2):323-33.
20. Scheinman MM, Brawn MA, Rapaport E. Critical assessment of use of central venous oxygen saturation as a mirror of mixed venous oxygen in severely ill cardiac patients. Circulation. 1969;40:165-72.
21. Vena Cava Superior. En: Wikipedia, la enciclopedia libre; 2003. [Consultado: 8 de Noviembre de 2007. Disponible en:
http://es.wikipedia.org/wiki/Vena_cava_superior
22. Llanio R, Fernández JE, Pérez FC, Fernández JA, Pena A, Rodríguez R, et al. Propedéutica clínica y fisiopatología. 4ta ed. La Habana: Pueblo y Educación; 1988.
23. 23.-Álvarez ME, Vázquez I, Medina Z, Valdivia I. Complicaciones relacionadas con catéter intravascular en niños ingresados en cuidados intensivos. Rev Cubana Pediatr. 1998;70(1):18-20.
24. Ormea A, Leyva F. Cateterismo venoso central y perforación de miocardio: presentación de un caso. Rev Med Hered. 1998;9(3):11-13.
25. Cheverri S, Pimiento JM. Acceso Venoso Central. En: Guías de urgencias; 2006. Disponible en:
http://www.fepafem.org.ve/Guias_de_Urgencias/Trauma/Acceso_venoso_central.pdf
26. History. In: ABL 510 Operator’s Manual. Denmark: Radiometer Coppenhaggen: 2002. p. 1-4.
27. Special calculations program. In: ABL 510 Operator’s Manual. Denmark: Radiometer Coppenhaggen; 2002. p. 4-18.
28. Special calculations program. In: L 550 Operator’s Manual. Denmark: Radiometer Coppenhaggen; 2002. p. 9-13.
29. Lequeux PY, Bouckaert Y, Sekkat H, Van der Linden P, Stefanidis C, Huynh CH, et al. Continuous mixed venous and central venous oxygen saturation in cardiac surgery with cardiopulmonary bypass. Eur J Anaesthesiol. 2010 Mar;27(3):295-9.
30. Rincón O. Atención de enfermería al postoperatorio de cirugía cardíaca con Circulación Extracorpórea. Memorias del VII Simposio de Actualizaciones en Enfermería. Revista de Enfermería [Internet]. 2007 [citado 13 de Oct de 2007]. Disponible en:
http://encolombia.com/medicina/enfermeria/enfermeria4401-memorias.htm
31. Dueñas C, García C, Jaramillo A, Tous A, Ortiz AP. Efectos de las maniobras de reclutamiento alveolar en el postoperatorio de cirugía cardiovascular. Revista de Neumología [Internet]. 2007 [citado 6 de Mayo de 2007]. Disponible en: http://encolombia.com/medicina/neumologia/neum14402efectos.htm
32. Barker SJ. New Developments in Oxygen Transport and Monitoring. [Presented at Congress]. In: The 79th Clinical and Scientific of the International Anesthesia Research Society, Honolulu, Hawai, 2005 Mar 11-15.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
