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Agreement of central venous saturation and mixed venous saturation in cardiac surgery patients

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Abstract

Objective

Comparison of the bias and the limits of agreement (LOA; 2 SD) of the central venous saturation (ScvO2) before, during and after coronary artery bypass graft surgery with a simultaneous measurement of the mixed venous saturation (SvO2).

Design and setting

Prospective controlled study in a university hospital department of anaesthesiology.

Patients

60 patients with coronary artery bypass surgery, 300 paired measurements of SvO2 and ScvO2.

Measurements and results

ScvO2 and SvO2 were analysed after induction of anaesthesia 15 min after cardiopulmonary bypass and 1, 6 and 18 h after admission to the intensive care unit. Regression analysis for the pooled measurements of ScvO2 and SvO2 showed a correlation R 2 = 0.52. After induction of anaesthesia 15 min after weaning from cardiopulmonary bypass and 6 h after admission to the intensive care unit the correlation coefficient was R 2 = 0.46, on admission to the intensive care unit it was R 2 = 0.42, and at 18 h it was R 2 = 0.38. Bland–Altman analysis for the measurements of ScvO2 and SvO2 showed a mean bias and LOA of 0.3% and −11.9 to +12.4%. In patients with a low ScvO2 there was a trend to overestimate the SvO2 by using the ScvO2. The only factor that influenced the ΔSvO2 − ScvO2 was the oxygen extraction rate (R 2 = 0.16). In patients with ScvO2 below 70% this association was more pronounced (R 2 = 0.60).

Conclusions

Our findings demonstrate that oxygen extraction rate is the major factor in the difference between SvO2 and ScvO2. Under certain circumstances ScvO2 differed substantially from SvO2. Therefore in selected patients both parameters should be monitored to exclude general or focal hypoperfusion.

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Acknowledgements

The authors appreciate the diligent linguistic revision of this manuscript by Mrs. Sirka Sander (certified English translator) and thank their colleagues Mrs. Anja Heinemann (all from the Department of Anaesthesiology and Intensive Care Medicine, Charité University Medicine Berlin, Charité Campus Mitte/Campus Virchow Klinikum, Germany) for helping with the acquisition of the data, as well as Mrs. Gerda Siebert, Dipl.-Math., Department of Medical Biometry, Charité University Medicine Berlin, Germany) for the detailed statistical advice in analysing the data.

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Authors and Affiliations

  1. Department of Anaesthesiology and Intensive Care Medicine, University Hospital Charité, Campus Charité Mitte/Campus Virchow Klinikum, Charité Universitätsmedizin, Charitéplatz 1, 10098, Berlin, Germany

    Michael Sander, Claudia D. Spies, Achim Foer, Lisa Weymann, Jan Braun, Thomas Volk & Christian von Heymann

  2. Department of Cardiovascular Surgery, University Hospital Charité, Campus Charité Mitte/Campus Virchow Klinikum, Charité Universitätsmedizin, Charitéplatz 1, 10098, Berlin, Germany

    Herko Grubitzsch

Authors
  1. Michael Sander
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  2. Claudia D. Spies
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  3. Achim Foer
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  4. Lisa Weymann
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  5. Jan Braun
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  6. Thomas Volk
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  7. Herko Grubitzsch
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  8. Christian von Heymann
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Corresponding author

Correspondence to Michael Sander.

Additional information

This study was financially supported by a research grant from the German Research Society (DFG-SA 1346/4–1) and institutional research grants of the Charité Medical School.

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Sander, M., Spies, C.D., Foer, A. et al. Agreement of central venous saturation and mixed venous saturation in cardiac surgery patients. Intensive Care Med 33, 1719–1725 (2007). https://doi.org/10.1007/s00134-007-0684-1

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  • DOI: https://doi.org/10.1007/s00134-007-0684-1

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