[Continuous Svo2 measurements and co-oximetry are not interchangeable immediately after cardiopulmonary bypass].
OBJECTIVE
To determine the accuracy of continuous (in vivo) measurement of mixed venous oxygen saturation (SvO(2)), using a fibreoptic catheter, in patients having had cardiopulmonary bypass (CPB).


METHODS
Using a pulmonary arterial catheter, we prospectively studied 14 patients (age 64 +/- 8) having had cardiopulmonary bypass. Mean hematocrit was 30 +/- 4%. The catheter was calibrated in vitro and in vivo, according to the manufacturer's instructions. Fifty-six simultaneous measurements of continuous SvO(2) (CSvO(2)) and measured SvO(2) (MSvO(2)) were taken with a co-oxymeter and the paired values were analyzed by the linear regression method. To make the two sets of measurements interchangeable, we established, a priori, a maximum limit of 3% (approximately 5% of the measurement), as being an acceptable difference between the two types of measurements.


RESULTS
All the measurements were obtained within four hours of the placement of the catheter. CSvO(2) was weakly correlated with MSvO(2), with a correlation coefficient of r(2) = 0.49 (P < 0.001). The Bland-Altman analysis demonstrates an objective mean bias of 0.8 +/- 3%, with 36% of the values measured falling outside clinically acceptable limits. For values of CSvO(2) <or= 65%, the measurements were not correlated (P = NS). The bias was -2 +/- 7%, and 56% of the values measured fell outside clinically acceptable limits.


CONCLUSIONS
Our results demonstrate that, in the immediate aftermath of cardiopulmonary bypass, the continuous measurement of SvO(2) and the co-oxymetry determination of mixed blood is not inter-changeable. Other studies will be necessary to confirm these results and enable us to understand the pathophysiological phenomena accounting for the lack of agreement between the two methods.
Bendjelid
Karim
K
De la Division des Soins Intensifs de Chirurgie, Hôpitaux Universitaires de Genève, Genève, Suisse. Karim.Bendjelid@hcuge.ch
Schutz
Nicolas
N
Suter
Peter M
PM
Romand
Jacques-A
JA
D002315:Cardiopulmonary Bypass; D002407:Catheterization, Swan-Ganz / Q000295:instrumentation* / Q000706:statistics & numerical data; D005336:Fiber Optic Technology / Q000295:instrumentation; D006400:Hematocrit; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000706:statistics & numerical data; D010092:Oximetry / Q000706:statistics & numerical data; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies
D010100:Oxygen