• Pouya Motazedian, Nickolas Beauregard, Isabelle Letourneau, Ida Olaye, Sarah Syed, Eric Lam, Pietro Di Santo, Rebecca Mathew, Edward G Clark, Manish M Sood, Manoj M Lalu, Benjamin Hibbert, and Ann Bugeja.
• University of Ottawa School of Epidemiology and Public Health, Ottawa, ON, Canada.
• Crit. Care Med. 2024 Nov 1; 52 (11): e568e577e568-e577.

ObjectivesThe objectives of our systematic review and meta-analyses were to determine the diagnostic accuracy of central venous oxygen saturation (Scv o2 ) in estimating mixed venous oxygen saturation (Sv o2 ) and cardiac index in critically ill patients.Data SourcesA systematic search using MEDLINE, Cochrane Central Register of Controlled Trials, and Embase was completed on May 6, 2024.Study SelectionStudies of patients in the ICU for whom Scv o2 and at least one reference standard test was performed (thermodilution and/or Sv o2 ) were included.Data ExtractionIndividual patient data were used to calculate the pooled intraclass correlation coefficient (ICC) for Sv o2 and Spearman correlation for cardiac index. The Quality Assessment of Diagnostic Accuracy Studies-2 and Grading Recommendations Assessment, Development, and Evaluation tools were used for the risk of bias and certainty of evidence assessments.Data SynthesisOf 3427 studies, a total of 18 studies with 1971 patients were identified. We meta-analyzed 16 studies (1335 patients) that used Sv o2 as a reference and three studies (166 patients) that used thermodilution as reference. The ICC for reference Sv o2 was 0.83 (95% CI, 0.75-0.89) with a mean difference of 2.98% toward Scv o2 . The Spearman rank correlation for reference cardiac index is 0.47 (95% CI, 0.46-0.48; p < 0.0001).ConclusionsThere is moderate reliability for Scv o2 in predicting Sv o2 in critical care patients with variability based on sampling site and presence of sepsis. There is limited evidence on the independent use of Scv o2 in predicting cardiac index.Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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