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首页> 外文期刊>American Journal of Physiology >Novel noninvasive estimation of mixed venous oxygen saturation by echocardiography and expired gas analysis
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Novel noninvasive estimation of mixed venous oxygen saturation by echocardiography and expired gas analysis

机译：Novel noninvasive estimation of mixed venous oxygen saturation by echocardiography and expired gas analysis

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Mixed venous oxygen (O2) saturation (SVO2) is an important measure for evaluating the sufficiency of cardiac output (CO) relative to whole body O2consumption (VO2), while clinical use is limited to the required invasive catheterization. According to Fick's equation, VO2(mL/min) =CO (L/min) Hb (g/dL) 1.36 (mL/g) (SaO2SVO2)/10 (Hb = hemoglobin concentration, SaO2= arterial blood O2 saturation). Because VO2, CO, Hb, and SaO2can be measured noninvasively with expired gas analysis, echocardiography, a simple blood test, and percutaneous O2 saturation, respectively, SVO2can be calculated noninvasively. We hypothesized that noninvasively calculated SVO2shows a significant correlation and agrees well with invasively measured SVO2. In 47 patients (29 men; mean age, 70 ± 12 yr) who underwent right heart catheterization, SVO2was directly measured by sampling pulmonary artery blood. Noninvasively calculated SVO2was also obtained by the method described above. The calculated SVO2was significantly correlated with the measured SVO2(r = 0.79, P 0.001) and was significantly smaller than the measured SVO2(70 ± 5.1 vs. 72.1 ± 4.9%, P 0.001). Bias at SVO2was 2.2% (95% confidence interval, 3.2 to 1.1%) with limits of agreement from 9.5 to 5.2%, demonstrating acceptable agreement. The optimal cutoff value of calculated SVO2was 69% for reduced measured SVO2 70% with an area under the curve of 0.94. Reduced calculated SVO2 69% indicated a sensitivity of 92.9% and a specificity of 90.9% for reduced measured SVO2 70%. Noninvasive SVO2calculated from echocardiography, expired gas analysis, percutaneous arterial blood O2 saturation, and hemoglobin level significantly correlated and agreed well with direct SVO2measured by catheterization. This novel method allows for practical evaluation of SVO2to assess the sufficiency of CO according to whole body metabolism.

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