Validation of a Novel Method for Noninvasive Mixed Venous Oxygen Saturation Monitoring in Anesthetized Children.

IF 4.6 2区医学 Q1 ANESTHESIOLOGY

Anesthesia and analgesia Pub Date : 2024-10-01 Epub Date: 2024-08-02 DOI:10.1213/ANE.0000000000007083

Anders Svedmyr, Kristoffer Steiner, Andreas Andersson, Gunnar Sjöberg, Magnus Hallbäck, Mats Wallin, Per-Arne Lönnqvist, Jacob Karlsson

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引用次数: 0

Abstract

Background: Mixed venous oxygen saturation (SvO 2 ) is a critical variable in the assessment of oxygen supply and demand but is rarely used in children due to the invasive nature of pulmonary artery catheters. The aim of this prospective, observational study was to investigate the accuracy of noninvasively measured SvO 2 acquired by the novel capnodynamic method, based on differential Fick equation (Capno-SvO 2 ), against gold standard CO-oximetry.

Methods: Capno-SvO 2 was compared to SvO 2 measured by pulmonary artery blood gas CO-oximetry in children undergoing cardiac catheter interventions and subjected to moderate hemodynamic challenges. Bland-Altman analysis was used to describe the agreement of absolute values between CO-oximetry and Capno-SvO 2 , and a concordance rate was calculated to evaluate the ability of Capno-SvO 2 to track change.

Results: Twenty-five procedures were included in the study. Capno-SvO 2 showed a bias toward CO-oximetry of +3 percentage points; upper and lower limits of agreement were +11 percentage points (95% confidence interval [CI], 9-14) and -5 percentage points (95% CI, -8 to -3), respectively. The concordance rate was 92% (95% CI, 89-96).

Conclusions: In conclusion, this first clinical application of a novel concept for noninvasive SvO 2 monitoring without the need for a pulmonary artery catheter indicates that Capno-SvO 2 generates absolute values and trending capacity in close agreement with the gold standard reference method.

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麻醉儿童无创混合静脉血氧饱和度监测新方法的验证。

背景：混合静脉血氧饱和度（SvO2）是评估供氧和需氧的一个关键变量，但由于肺动脉导管的侵入性而很少用于儿童。这项前瞻性观察研究的目的是探讨基于费克微分方程的新型帽动力法（Capno-SvO2）与黄金标准二氧化碳氧饱和度测量法无创测量 SvO2 的准确性：方法：在接受心脏导管介入治疗和中度血流动力学挑战的儿童中，将 Capno-SvO2 与肺动脉血气 CO- 氧饱和度测量法测量的 SvO2 进行比较。使用 Bland-Altman 分析描述 CO- 氧饱和度与 Capno-SvO2 绝对值的一致性，并计算一致性率以评估 Capno-SvO2 跟踪变化的能力：结果：这项研究共纳入了 25 例手术。Capno-SvO2 与 CO-oximetry 的偏差为 +3 个百分点；一致性的上限和下限分别为 +11 个百分点（95% 置信区间 [CI]，9-14）和 -5 个百分点（95% CI，-8--3）。一致率为 92% (95% CI, 89-96)：总之，无需肺动脉导管的无创 SvO2 监测新概念的首次临床应用表明，Capno-SvO2 生成的绝对值和趋势能力与金标准参考方法非常接近。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anesthesia and analgesia 医学-麻醉学

CiteScore

9.90

自引率

7.00%

发文量

817

审稿时长

2 months

期刊介绍： Anesthesia & Analgesia exists for the benefit of patients under the care of health care professionals engaged in the disciplines broadly related to anesthesiology, perioperative medicine, critical care medicine, and pain medicine. The Journal furthers the care of these patients by reporting the fundamental advances in the science of these clinical disciplines and by documenting the clinical, laboratory, and administrative advances that guide therapy. Anesthesia & Analgesia seeks a balance between definitive clinical and management investigations and outstanding basic scientific reports. The Journal welcomes original manuscripts containing rigorous design and analysis, even if unusual in their approach.