• Xiaohong Zhang, Jiandong Wang, Yun Dong, and Youdai Chen.
• Emergency Intensive Care Unit, Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China.
• J Crit Care. 2015 Aug 1;30(4):768-72.

ObjectivesTo investigate the relationship between central venous oxygen saturation (ScvO(2)) and femoral venous oxygen saturation (SfvO(2)) in a large group of critically ill patients.DesignObservational study.PatientsA group of unselected critically ill patients with central line placed into superior vena cava were included.SettingA 26-bed intensive care unit in a tertiary referral hospital.InterventionsNone.Measurements And Main ResultsVenous blood samples of superior vena cava and femoral vein were collected within an interval of 5 to 15 minutes and analyzed with blood gas/electrolyte analyzer immediately. Although SfvO(2) was significantly correlated with ScvO(2) (r = 0.493, P < .001; Pearson correlation, 2 tailed), the limits of agreement were wide (up to 61% to -41%) between the 731 pairs of blood samples collected from 357 patients. The fit line of scatter diagram ScvO(2) vs SfvO(2) had a large intercept (48.68%) and a low slope (0.2978); ScvO(2) was still around 50% while SfvO(2) was nearing 0%. The distribution of blood flow, measured with Doppler ultrasound, had a similar trend in 237 patients and 412 measurements. The ratio of femoral artery flow over common carotid artery flow varied widely (from 0 to 7.13). Blood flow was not distributed in a fixed ratio to the superior vena cava-drained organs and tissues.ConclusionsCentral venous oxygen saturation was not representative of the whole systemic circulation in critically ill patients. Central venous oxygen saturation alone might be misleading in goal-directed therapy.Copyright © 2015 Elsevier Inc. All rights reserved.

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