Mixed venous oxygen saturation during cardiopulmonary bypass poorly predicts regional venous saturation

L. B. McDaniel, J. B. Zwischenberger, R. A. Vertrees, L. Nutt, T. Uchida, T. Nguyen, George Kramer, F. McLellan

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Abstract

Mixed venous oxygen saturation is generally accepted as an indicator of adequacy of systemic oxygen delivery; however, cardiopulmonary bypass (CPB) may alter this relationship. Major postoperative complications potentially secondary to inadequate oxygen delivery during CPB indicate that mixed venous oxygen saturation may not detect regional venous desaturation during CPB. We therefore tested the hypothesis that mixed venous oxygen saturation and pH did not predict regional venous oxygen saturations and pH during 2 h of bypass in a swine model. Six immature swine (27-34 kg) received standard normothermic CPB. Sagittal sinus and portal vein oxygen saturations and blood gases were measured at 30, 60, 90, and 120 min of bypass. Although the venous reservoir oxygen saturation remained unchanged during 2 h of bypass, sagittal sinus saturation and pH decreased significantly (66% ± 3.3% to 33% ± 2.2% and 7.38 ± 0.04 to 7.23 ± 0.05, respectively). Likewise in the portal vein, oxygen saturation and pH also decreased (82% ± 2.4% to 59.3% ± 3.9% and 7.39 ± 0.03 to 7.27 ± 0.06, respectively). We conclude that profound regional venous desaturation and progressive regional acidemia may go undetected even when a standard pump flow rate of 100 mL · kg-1 · min- 1 is used and mixed venous oxygen saturation is normal.

Original languageEnglish (US)
Pages (from-to)466-472
Number of pages7
JournalAnesthesia and Analgesia
Volume80
Issue number3
DOIs
StatePublished - 1995
Externally publishedYes

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ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

McDaniel, L. B., Zwischenberger, J. B., Vertrees, R. A., Nutt, L., Uchida, T., Nguyen, T., Kramer, G., & McLellan, F. (1995). Mixed venous oxygen saturation during cardiopulmonary bypass poorly predicts regional venous saturation. Anesthesia and Analgesia, 80(3), 466-472. https://doi.org/10.1097/00000539-199503000-00006