Perioperative evaluation of a new mixed venous oxygen saturation catheter in cardiac surgical patients

Abstract

Fiberoptic pulmonary artery flotation catheters have gained clinical acceptance for continuous monitoring of mixed venous oxygen saturation (Sv̄O 2), especially in the management of hemodynamically unstable patients. Therefore, the performance of the oximetry system used is extremely important. The accuracy and stability of a new two-wavelength oximetry pulmonary artery catheter and SAT-2 oximeter were assessed in adult patients during and following cardiac surgery. After in vitro calibration of the system, the catheter was inserted through the right internal jugular vein and positioned in the pulmonary artery prior to induction of anesthesia. During the study period, the system was updated for hemoglobin changes of 1.8 g / dL or more. In vivo Sv̄O 2 values obtained by the oximetry catheter were compared with those determined with a reference oximeter from simultaneously drawn mixed venous blood specimens at different intervals. A total of 604 paired data points from 52 patients were analyzed, 572 (94.7%) of which were within the 95% confidence interval. Overall bias was −1.7% ± 3.5% (SD). The results suggest that over the time course of the study, in vivo Sv̄O 2 values obtained with the two-wavelength catheter and the SAT-2 oximeter closely approximated Sv̄O 2 measured with a reference oximeter from mixed venous blood samples ( r = 0.917; SEE 3.5%) in cardiac surgical patients in whom marked physiological changes occur.