• Scand J Trauma Resus · Sep 2018

    Observational Study

    Peripheral measurements of venous oxygen saturation and lactate as a less invasive alternative for hemodynamic monitoring.

    • Raphaelle Avigael Chemtob and Hasse Møller-Sørensen.
    • Department of Cardiothoracic Anaesthesiology, University Hospital of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. raphaellechemtob@gmail.com.
    • Scand J Trauma Resus. 2018 Sep 10; 26 (1): 75.

    BackgroundPeripheral measurement of venous oxygen saturation and lactate is a less invasive alternative to monitor tissue oxygenation as compared to measurements from a central venous catheter. However, there is a lack of evidence to support the use of peripheral measurements. In this study, we investigated the agreement between central and peripheral venous oxygen saturation and lactate.MethodsWe conducted a prospective observational study including 115 patients who underwent elective cardiac surgery between April and May 2015 at Rigshospitalet, Copenhagen, Denmark. Measurements were obtained simultaneously at induction of anaesthesia, upon arrival in the ICU and 3-4 h postoperatively. Bias and trending ability was identified using Bland-Altman analysis and a four-quadrant plot.ResultsBias was 13.37% for venous oxygen saturation preoperatively (95% CI: 11.52-15.22, LoA: ±19.10, PE: 22.08%), 11.29% at arrival to the ICU (95% CI: 8.81-13.77, LoA: ±25.10, PE: 32.39%) and 16.49% at 3-4 h postoperatively (95% CI: 14.16-18.82, LoA: ±21.20, PE: 26.82%). A four-quadrant plot demonstrated an 89% concordance. Central and peripheral lactate showed a bias of 0.14 mmol/L preoperatively (95% CI: 0.11-0.17, LoA: ±0.30, PE: 32.08%), 0.16 mmol/L at arrival to ICU (95% CI: 0.09-0.23, LoA: ±0.70, PE: 38.88%) and 0.23 mmol/L at 3-4 h postoperatively (95% CI: 0.11-0.35, LoA: ±0.50, 25.18%).DiscussionMeasurements of peripheral oxygen saturation and lactate may be valuable in an emergency setting, avoiding unnecessary and time consuming application of a CVC.ConclusionWe found a high bias but an acceptable trending ability between central and peripheral venous oxygenation. Central and peripheral lactate had excellent agreement. Further studies are necessary to validate the use of peripheral venous samples to identify patients at risk of impaired tissue oxygenation.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…