Diagnostic accuracy of central venous saturation in estimating mixed venous saturation is proportional to cardiac performance among cardiac surgical patients.

Gašparović, Hrvoje; Gabelica, Rajka; Ostojić, Zvonimir; Kopjar, Tomislav; Petričević, Mate; Ivančan, Višnja; Biočina, Bojan

doi:10.1016/j.jcrc.2014.04.012.

Pregled bibliografske jedinice broj: 736130

Diagnostic accuracy of central venous saturation in estimating mixed venous saturation is proportional to cardiac performance among cardiac surgical patients.

Gašparović, Hrvoje; Gabelica, Rajka; Ostojić, Zvonimir; Kopjar, Tomislav; Petričević, Mate; Ivančan, Višnja; Biočina, Bojan

Diagnostic accuracy of central venous saturation in estimating mixed venous saturation is proportional to cardiac performance among cardiac surgical patients. // Journal of critical care, 29 (2014), 828-834 doi:10.1016/j.jcrc.2014.04.012. (podatak o recenziji nije dostupan, članak, ostalo)

CROSBI ID: 736130 Za ispravke kontaktirajte CROSBI podršku putem web obrasca

Naslov
Diagnostic accuracy of central venous saturation in estimating mixed venous saturation is proportional to cardiac performance among cardiac surgical patients.

Autori
Gašparović, Hrvoje ; Gabelica, Rajka ; Ostojić, Zvonimir ; Kopjar, Tomislav ; Petričević, Mate ; Ivančan, Višnja ; Biočina, Bojan

Izvornik
Journal of critical care (0883-9441) 29 (2014); 828-834

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, ostalo

Ključne riječi
Cardiac surgery ; Central venous saturation ; Mixed venous saturation ; Pulmonary artery catheter

Sažetak
PURPOSE: Advanced hemodynamic monitoring in cardiac surgery translates into improvement in outcomes. We evaluated the relationship between central venous (ScvO2) and mixed venous (SvO2) saturations over the early postoperative period. The adequacy of their interchangeability was tested in patients with varying degrees of cardiac performance. METHODS: In this prospective observational study, we evaluated 156 consecutive cardiac surgical patients in an academic center. The ScvO2 and SvO2 data were harvested from 468 paired samples taken preoperatively (T0), after weaning from cardiopulmonary bypass (T1) and on postoperative day 1 (T2). RESULTS: The relationship between ScvO2 and SvO2 was inconsistent, with inferior correlations in patients with lower cardiac indices (CI) (Pearson r(2) = 0.37 if CI ≤2.0 L/min per square meter vs r(2) = 0.73 if CI >2.0 L/min per square meter, both P < .01). Patients with lower CI also had wider 95% limits of agreement between SvO2 and ScvO2. The proportion of patients with a negative SvO2-ScvO2 gradient increased over time (48/156 [31%] at T0 to 73/156 [47%] at T2 ; P < .01). This subgroup more frequently required inotropes at T2 than patients with a positive SvO2- ScvO2 gradient (odds ratio, 6.46 [95% confidence interval, 0.81- 51.87], P = .06) and also had higher serum lactate levels (1.5 ± 0.8 vs 1.0 ± 0.4 ; P < .01). CONCLUSIONS: The diagnostic accuracy of ScvO2 for estimating SvO2 is proportional to cardiac performance. A negative SvO2-ScvO2 gradient at T2 correlated with inotropic support requirement, higher operative risk score, age, lactate level, and duration of cardiopulmonary bypass.

Izvorni jezik
Engleski

POVEZANOST RADA

Ustanove:
Medicinski fakultet, Zagreb

Profili:

Višnja Ivančan (autor)