title: Continuous monitoring of mixed venous oxygen saturation during orthotopic liver transplantation.
abstract: Hemodynamic management is an important issue concerning anesthesia for orthotopic liver transplantation (OLT). Mixed venous oxygen saturation (SvO2) is considered a good index of tissue oxygenation, but controversy exists about the usefulness of monitoring this parameter in different types of surgery. Therefore, a prospective study was performed to determine changes in SvO2 during OLT and to study the correlation between SvO2 and hemodynamic measurements. Thirty patients undergoing transplantation for end-stage liver disease were divided into two groups: group 1 (n = 15, aged 42 +/- 11 years [mean +/- SD]) without venovenous bypass (VVB), and group 2 (n = 15, aged 43 +/- 10 years) with VVB. SvO2 was greater than 74% throughout the procedure and remained stable during dissection and the anhepatic phase. There was a significant increase in SvO2 after unclamping the portal vein in group 1, whereas a significant decrease was observed during the first hour following reperfusion in group 2. There was no correlation among SvO2 and oxygen consumption, arterial oxygen saturation, (SaO2), or hemoglobin concentrations. A statistically significant correlation was found between SvO2 and cardiac index in both groups (group 1: r = 0.58, P = 0.01; group 2: r = 0.51, P = 0.01), but the correlation was relatively poor. Continuous monitoring of SvO2 may be useful, but cannot substitute for intermittent determinations of other hemodynamic or oxygenation parameters.
authors.affiliation: Department of Anesthesiology, Paul Brousse Hospital, Université Paris-Sud, Villejuif, France.
authors.forename: E
authors.initials: E
authors.lastname: Jugan
authors.forename: P
authors.initials: P
authors.lastname: Albaladejo
authors.forename: P
authors.initials: P
authors.lastname: Jayais
authors.forename: A
authors.initials: A
authors.lastname: Descorps-Declere
authors.forename: C
authors.initials: C
authors.lastname: Ecoffey
mesh_terms: D000328:Adult; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D016031:Liver Transplantation / Q000502:physiology*; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D010100:Oxygen