Effect of vasoactive treatment on the relationship between mixed venous and regional oxygen saturation.
OBJECTIVE
To evaluate the relationship between the mixed venous (SvO2), hepatic, and femoral venous oxygen saturations before and during sympathomimetic drug infusions.


METHODS
Case series.


METHODS
Tertiary care center.


METHODS
Twenty-four ICU patients: postoperative open-heart surgery patients (n = 12), patients with septic shock (n = 8), and patients with acute respiratory failure (n = 4).


METHODS
In postoperative open-heart surgery patients and patients with respiratory failure, cardiac output was increased by at least 25% following therapy with either dobutamine or dopamine. Patients with septic shock were treated with either dopamine or norepinephrine to correct hypotension.


RESULTS
Vasoactive drug infusions increased cardiac index and oxygen delivery by 34% and oxygen consumption by 8%. SvO2 increased (62.6 +/- 6.7% vs. 69.5 +/- 6.0%, p less than .001). Although cardiac index was the most important determinant of SvO2, the correlation between cardiac index and SvO2 was weak (r2 = .32). The hepatic and femoral venous saturations also increased (49.0 +/- 12.1% vs. 59.4 +/- 9.8%, p less than .01, and 51.9 +/- 16.6% vs. 63.4 +/- 9.8%, p less than .001, respectively) in response to vasoactive treatment. The mean gradient between SvO2 and hepatic venous saturation was 11.9 +/- 8.7% and was independent of the clinical condition and baseline SvO2. The hepatic venous oxygen saturation increased in parallel with SvO2 regardless of the initial SvO2 value.


CONCLUSIONS
The individual values of SvO2 have no predictive value concerning regional oxygen transport. The parallel increase in SvO2 and hepatic venous oxygen saturation suggests that the vasoactive treatment did not compromise splanchnic oxygenation.
Department of Intensive Care, Kuopio University Hospital, Finland.
E
E
Ruokonen
J
J
Takala
A
A
Uusaro
D000208:Acute Disease; D001026:Coronary Artery Bypass; D004280:Dobutamine / Q000494:pharmacology; D004298:Dopamine / Q000494:pharmacology; D006801:Humans; D008102:Liver Circulation / Q000187:drug effects; D009638:Norepinephrine / Q000494:pharmacology; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption / Q000187:drug effects*; D012131:Respiratory Insufficiency / Q000503:physiopathology*; D012772:Shock, Septic / Q000503:physiopathology*; D014662:Vasoconstrictor Agents / Q000494:pharmacology*
D014662:Vasoconstrictor Agents; D004280:Dobutamine; D010100:Oxygen; D004298:Dopamine; D009638:Norepinephrine