Key result
Continuous ScvO2 and SvO2 show poor agreement around cardiac surgery with a ~4-point mean bias.
Why the study?
Does continuous central venous oxygen saturation (ScvO2) monitoring agree sufficiently with mixed venous oxygen saturation (SvO2) monitoring to be used interchangeably in patients undergoing elective cardiac surgery?
Observational (n=15)
No
Does continuous central venous oxygen saturation (ScvO2) monitoring agree sufficiently with mixed venous oxygen saturation (SvO2) monitoring to be used interchangeably in patients undergoing elective cardiac surgery?
Continuous ScvO2 and SvO2 measurements exhibit wide limits of agreement and considerable variability during and after cardiac surgery, meaning ScvO2 cannot directly replace SvO2 as an interchangeable absolute hemodynamic target.
Answers are grounded in this paper and cite their sources.
ScvO2 cannot substitute for SvO2 as an interchangeable target after cardiac surgery; supports prior evidence of poor agreement in critically ill patients.
Monitoring of mixed venous oxygen saturation (Sv̄O 2 ) allows assessment of the global balance between oxygen supply and demand. Sv̄O 2 measurement requires the insertion of a pulmonary artery catheter (PAC) whereas central venous oxygen saturation (ScvO 2 ) monitoring only requires a central venous catheter. The aim of this study was to assess how continuous measurements of ScvO 2 relate to simultaneous measurements of Sv̄O 2 during and after cardiac surgery. Continuous Sv̄O 2 and ScvO 2 measurements in 15 patients undergoing elective cardiac surgery were recorded each minute for 24 hours. Bland-Altman analysis of 9,382 paired data points for Sv̄O 2 and ScvO 2 revealed a mean bias of 4.4% (95% Cl +22.3, −13.6%). Considerable inter- and intra-individual variability was noted. Based on these data and previous studies, ScvO 2 and Sv̄O 2 are not interchangeable variables.
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Sekkat et al. (2009) conducted an observational in Elective cardiac surgery under cardiopulmonary bypass (n=15). Continuous central venous oxygen saturation (ScvO2) monitoring via central venous catheter vs. Simultaneous continuous mixed venous oxygen saturation (SvO2) monitoring via pulmonary artery catheter was evaluated on Agreement (mean bias) between continuous SvO2 and ScvO2 measurements over 24 hours (MD 4.4%, 95% CI -13.6 to +22.3). Continuous ScvO2 and SvO2 measurements showed poor agreement during and after cardiac surgery with a mean bias of 4.4% (95% CI -13.6% to +22.3%), making them non-interchangeable.
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