Reliability of continuous jugular venous bulb hemoglobin oxygen saturation during cardiac surgery.
OBJECTIVE
To evaluate the accuracy and reliability of continuous measurement of jugular venous bulb hemoglobin oxygen saturation (SjvO2) with a fiberoptic catheter (SjvO(2OX)) during cardiac surgery versus simultaneous paired measurements of hemoglobin oxygen saturation by the Hemoximeter (SjVO(2HEM); Radiometer, Copenhagen, Denmark) and indirect estimations of hemoglobin oxygen saturation from measurements of partial pressure of oxygen in blood gases (SjVO(2BG)).


METHODS
A prospective study.


METHODS
American Hellenic Educational Progressive Association General Hospital, University Hospital of Thessaloniki, Greece.


METHODS
Thirty patients undergoing elective aortocoronary artery bypass surgery.


METHODS
In addition to routine pressure monitoring, a 4F fiberoptic catheter was placed in the left jugular bulb by a retrograde internal jugular vein approach and SIvO(2OX) was continuously measured. Before insertion, each catheter was calibrated in vitro.


RESULTS
One hundred twelve simultaneous paired recordings between SjvO(2OX) and SjVO2BG were performed to define the accuracy of SjVO(2OX) to SjVO(2BG). Sixty-one of 112 simultaneous paired recordings between SjvO(2OX) and SjVO(2HEM) and SjVO(2HEM) and SjVO(2BG) were performed to define the accuracy of SjvO(2OX) to the reference SjVO(2HEM) and the reliability of the SjVO(2BG) measurement to SjVO(2HEM). The fiberoptic catheter readings varied from underestimating to overestimating hemoglobin saturation by a mean of -5.35% to +9.67% and of -3.22% to +7.81% versus Blood Gas Analyzer (Ciba-Corning) and Co-Oximeter (OSM 2b Hemoximeter, Radiometer) values, respectively. The mean underestimation and overestimation of Co-Oximeter versus Blood Gas Analyzer values were -3.18% and +4.17%, respectively.


CONCLUSIONS
SjvO2 values obtained continuously from a jugular venous bulb fiberoptic catheter may give relatively accurate readings provided they are duly interpreted and errors caused by wall artifact or blood sampling are avoided.
Department of Anesthesia, AHEPA University Hospital, Thessaloniki, Greece.
E
E
Anastasiou
K
K
Gerolioliou
K
K
Karakoulas
M
M
Peftoulidou
M
M
Giala
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007601:Jugular Veins / Q000378:metabolism*; D008875:Middle Aged; D010092:Oximetry; D010100:Oxygen / Q000378:metabolism*; D011446:Prospective Studies
D006454:Hemoglobins; D010100:Oxygen