Effects of Increasing FiO2 on Venous Saturation During Cardiopulmonary Bypass in the Swine Model

Abstract

Adequacy of perfusion during cardiopulmonary bypass (CPB) is dependent on nutrient delivery and waste removal from the tissue. A recent study showed that over 75% of cardiopulmonary bypass procedures are completed using continuous venous saturation (SvO2) monitoring. The purpose of this study was to determine the effect of changing FiO2 concentration on SvO2. A total of eight mixed gender 45-kg swine were placed on CPB under moderate hypothermic conditions. Animals were divided evenly into two groups: Experimental, where FiO2 was increased to 100% and blood flow decreased to an SvO2 level of prechange in FiO2, and Control, where the same condition was created except no change in blood flow. Variables measured include hemodynamic, blood gas, intramyocardial pH, and lactic acid concentrations. In the experimental group, percentage change of blood flow was decreased from baseline 28.4% ± 12.5% (p < .005) as well as percentage change of oxygen delivery 23.9% ± 14.7% (p < .005). Systemic venous saturation percentage change was increased in both the experimental 14.4% ± 6.8% (p < .05) and control 11.2% ± 7.1% (p < .05) groups. Jugular venous saturation percentage change was decreased in the experimental group 7.8% ± 6.34% (p < .02), but not in the control animals. Myocardial venous saturation percentage change decreased in the experimental group to 3.73% ± 8.34% (p < .004). Experimental manipulation, however, did not significantly change jugular lactic acid concentrations or intramyocardial pH values. In conclusion, these results suggest that decreased blood flow adjusting for increased SvO2associated with high PaO2 did not result in significant reduction of adequacy of perfusion markers for organs studied.