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Clinical Investigations in Critical CareLack of Equivalence Between Central and Mixed Venous Oxygen Saturation
Section snippets
Materials and Methods
This was a prospective, sequential, observational study of patients who had been admitted to the George Washington University Hospital ICU over a period of 6 months. The study was approved by the institutional review board, and informed consent for participating in the study was obtained from the patient or from their next of kin.
We enrolled individuals of either sex who were > 18 years of age whose attending physicians determined that a PAC was required to guide fluid therapy. Enrollment in
Results
We enrolled 53 patients in the study, of whom 21 were women. Demographics and diagnoses for individuals are shown in Table 1. Thirty-two patients in the study were in the postoperative group, and 21 were in the medical group. All patients in the medical group were in shock, as defined by the use of vasopressor agents to maintain mean arterial pressure. Sepsis was the predominant diagnosis in the medical group (62%). Coronary artery bypass grafting and aortic or mitral valve replacement
Discussion
In the present study, we took blood from the right atrium to be representative of central venous blood. We exercised great care during the insertion of the PAC to position the proximal port approximately 3 cm above the tricuspid valve. Presumably, this position placed the Scvo2 sampling site anterior to the coronary sinus but sufficiently distal into the right atrium to allow for the mixing of superior and inferior vena cava blood. The location of this sampling site for measuring Scvo2 differs
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This study was financed in its entirety by The George Washington University Medical Center Department of Anesthesiology Research Fund.