Effect of vasoactive treatment on the relationship between mixed venous and regional oxygen saturation

    loading  Checking for direct PDF access through Ovid

Abstract

Objective

To evaluate the relationship between the mixed venous (SJOURNAL/ccme/04.02/00003246-199111000-00017/ENTITY_OV0456/v/2017-07-20T220806Z/r/image-pngo2), hepatic, and femoral venous oxygen saturations before and during sympathomimetic drug infusions.

Design

Case series.

Setting

Tertiary care center.

Patients

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).

Interventions

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.

Measurements and Main Results

Vasoactive drug infusions increased cardiac index and oxygen delivery by 34% and oxygen consumption by 8%. SJOURNAL/ccme/04.02/00003246-199111000-00017/ENTITY_OV0456/v/2017-07-20T220806Z/r/image-pngo2 increased (62.6 ± 6.7% vs. 69.5 ± 6.0%, p < .001). Although cardiac index was the most important determinant of SJOURNAL/ccme/04.02/00003246-199111000-00017/ENTITY_OV0456/v/2017-07-20T220806Z/r/image-pngo2, the correlation between cardiac index and SJOURNAL/ccme/04.02/00003246-199111000-00017/ENTITY_OV0456/v/2017-07-20T220806Z/r/image-pngo2 was weak (r2 = .32). The hepatic and femoral venous saturations also increased (49.0 ± 12.1% vs. 59.4 ± 9.8%, p < .01, and 51.9 ± 16.6% vs. 63.4 ± 9.8%, p < .001, respectively) in response to vasoactive treatment. The mean gradient between SJOURNAL/ccme/04.02/00003246-199111000-00017/ENTITY_OV0456/v/2017-07-20T220806Z/r/image-pngo2 and hepatic venous saturation was 11.9 ± 8.7% and was independent of the clinical condition and baseline SJOURNAL/ccme/04.02/00003246-199111000-00017/ENTITY_OV0456/v/2017-07-20T220806Z/r/image-pngo2. The hepatic venous oxygen saturation increased in parallel with SJOURNAL/ccme/04.02/00003246-199111000-00017/ENTITY_OV0456/v/2017-07-20T220806Z/r/image-pngo2 regardless of the initial SJOURNAL/ccme/04.02/00003246-199111000-00017/ENTITY_OV0456/v/2017-07-20T220806Z/r/image-pngo2 value.

Conclusions

The individual values of SJOURNAL/ccme/04.02/00003246-199111000-00017/ENTITY_OV0456/v/2017-07-20T220806Z/r/image-pngo2 have no predictive value concerning regional oxygen transport. The parallel increase in SJOURNAL/ccme/04.02/00003246-199111000-00017/ENTITY_OV0456/v/2017-07-20T220806Z/r/image-pngo2 and hepatic venous oxygen saturation suggests that the vasoactive treatment did not compromise splanchnic oxygenation.

Related Topics

    loading  Loading Related Articles