1Department of Anesthesiology and Intensive Care General Hospital Šibenik
DOI: 10.22514/SV21.042007.1 Vol.2,Issue 1,April 2007 pp.6-10
Published: 20 April 2007
Tissue hypoxia is the central pathophysiological process in shock and an important co-factor in the development of organ dysfunction. Hemodynamic parameters, usually used to assess the perfusion of organs and tissues, like arterial blood pressure, heart rate, urine output and blood gases can be normal in the presence of tissue hypoxia and cannot rule out
imbalances between global oxygen supply and demand. Mixed venous oxygen saturation (SvO2) is a sensitive indicator of the adequacy of whole-body tissue oxygenation. However, it requires the placement of a pulmonary artery catheter,
which is an invasive procedure with the possibility of numerous complications and is increasingly questioned due to the
lack of evidence that it improves outcome. Central venous oxygen saturation (ScvO2) requires the insertion of a central venous catheter, which is routinely used in most critically ill patients, but it reflects the adequacy of oxygenation in the brain
and upper part of the body and differs from SvO2. Still, it can be used as a surrogate for mixed venous oxygen saturation because the changes and trends of both variables parallel each other. Both variables are used extensively in the treatment of patients with severe sepsis, shock and trauma. In combination with other hemodynamic and biochemical parameters, they have diagnostic and prognostic value and allow for rational treatment of critically ill patients.
mixed venous oxygen saturation, central venous oxygen saturation, physiological monitor-ing, shock
JOŠKO ŽAJA. Venous oximetry. Signa Vitae. 2007. 2(1);6-10.
1. Martin WE, Cheung PW, Johnson CC, Wong KC: Continuous Monitoring of Mixed Venous Oxygen Saturation in Man. Anesth Analg 1973. 52(5):784-793.
2. Wei W, Zhaoqiong Z, Lunxu L, Yunxia Z, Min G, Fushan X, Jin L: A Pilot Study of Continuous Transtracheal Mixed Venous Oxygen Saturation Monitoring. Anesth Analg 2005. 101(2), 440-443.
3. McDaniel L, Zwischenberger J, Vertrees R, Nutt L, Uchida T, Nguyen T, Kramer G: Mixed Venous Oxygen Saturation During Cardiopulmonary Bypass Poorly Predicts Regional Venous Saturation, Anesth Analg 1995. 80(3):466-472.
4. Van der Hoeven M, Maertzdorf W, Blanco C: Mixed Venous Oxygen Saturation and Biochemical Parameters of Hypoxia During Progressive Hypoxemia in 10 to 14 Day Old Piglets, Pediatr Res 1997; 42(6):878-884.
5. Baratt-Boyes BG, Wood EH: The Oxygen Saturation of Blood in the Vena Cavae, Right Heart Chambers an Pulmonary Vessels of Healthy Subjects. J Lab Clin Med 1957; 50:93-106.
6. Vesely T, Central Venous Catheter Tip Position: A Continuing Controversy, J Vasc Interv. Radiol 2003; 14(5), 527-534.
7. Ladakis C, Myrianthefs P, Karabinis A, Karatzas G, Dosios T, Fildissis G, Gogas J, Baltopoulos G: Central Venous and Mixed Venous Oxygen Saturation in Critically Ill Patients. Respiration 2001; 68:279-285.
8. Turnaoglu S, Tugrul M, Camci E, Cakar N, Akinci O, Ergin P: Clinical Applicability of The Substitution of Mixed Venous Oxygen Saturation With Central venous Oxygen Saturation. J Cardiothorac Vasc Anesth 2001; 15:574-679.
9. Lee J, Wright F, Barber R, Stanley L: Central Venous Oxygen Saturation in Shock: A Study in Man. Anesthesiology 1972, 36:472-478.
10. Reinhart K, Kersting T, Fohring U, Schaffer M: Can Central-Venous Replace Mixed-Venous Oxygen Saturation Measurements During Anesthesia? Adv Exp Med Biol 1986; 200:67-72.
11. Reinhart K, Kuhn HJ, Hartog C, Bredle D: Continuous Central Venous and Pulmonary Artery Oxygen Saturation Monitoring in The Critically Ill. Intensive Care Med 2004; 30:1572-1578.
12. Edwards J, Mayall R: Importance of The Sampling Site for Measurement of Mixed Venous Oxygen Saturation in Shock. Crit Care Med 1998; 26(8):1356-1360.
13. Reinhart K, Rudolph T, Bredle D, Hannemann L, Cain S: Comparison of Central-Venous to Mixed-Venous Oxygen Saturation During Changes in Oxygen Supply/Demand. Chest1989; 95:1216-1221.
14. Dueck M, Klimek M, Appenrodt S, Weigand C, Boerner U: Trends but Not Individual Values of Central Venous Oxygen Saturation Agree with Mixed Venous Oxygen Saturation during Varying Hemodynamic Conditions. Anesthesiology 2005; 103:249-257.
15. Muir AL, Kirby BJ, King AJ, Miller HC: Mixed venous oxygen saturation in relation to cardiac output in myocardial infarction. BMJ 1970; 4:276-278.
16. Gattinoni L, Brazzi L, Pelosi P, Latini R, Tognoni G, Pesenti A, Fumagalli R: A trial of goal.oriented hemodynamic therapy in critically ill patients. ScO2 Collaborative Group. N Engl J Med 1995;333(16):1025-32
17. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001; 345:1368-1377.
18. Rady MY, Rivers EP, Martin GB, Smithline H, Appelton T, Nowak RM: Continuous central venous oximetry and shock index in the emergency department: use in evaluation of clinical shock. Am J Emerg Med 1992; 10:538-541.
19. Scalea TM, Hartnett RW, Duncan AO, Atweh NA, Phillips TF, Sclafani SJ, Fuortes M, Shaftan GW: Central venous oxygen saturation: a useful clinical tool in trauma patients. J Trauma 1990; 30:1539-1543.
20. Ander DS, Jaggi M, Rivers E, Rady MY, Levine TB, Levine AB, Masura J, Gryzbowski M: Undetected cardiogenic shock in patients with congestive heart failure presenting to the emergency department. Am J Cardiol 1998; 82:888-891.
21. Goldman RH, Klughaupt M, Metcalf T, Spivak AP, Harrison DC: Measurement of central venous oxygen saturation in patients with myocardial infarction. Circulation 1968, 38:941-946.
22. Nakazawa K, Hikawa Y, Saitoh Y, Tanaka N, Yasuda K, Amaha K: Usefulness of central venous oxygen saturation monitoring during cardiopulmonary resuscitation. A comparative case study with end-tidal carbon dioxide monitoring. Intensive Care Med 1994; 20:450-451.
23. Rivers EP, Martin GB, Smithline H, Rady MY, Schultz CH, Goetting MG, Appleton TJ, Nowak RM: The clinical implications of continuous central venous oxygen saturation during human CPR. Ann Emerg Med 1992; 21:1094-1101.
24. Rivers EP, Rady MY, Martin GB, Fenn NM, Smithline HA, Alexander ME, Nowak RM: Venous hyperoxia after cardiac arrest. Characterization of a defect in systemic oxygen utilization. Chest 1992; 102: 1787-1793.
25. Pearse R, Dawson D, Fawcett J, Rhodes A, Grounds RM, Bennett ED: Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomized, controlled trial. Crit Care 2005;9(6):R687-93.
26. Pearse R, Dawson D, Fawcett J, Rhodes A, Grounds RM, Bennett ED: Changes in central venous saturation after mayor surgery, and association with outcome. Crit Care 2005;9(6):R694-9
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