Petteri Holm, Jaana M Karhu, Tiina M Erkinaro, Pasi P Ohtonen, Janne H Liisanantti, Panu Taskinen, Hanna Säkkinen, Tero I Ala-Kokko, Timo I Kaakinen
{"title":"心脏手术后重症监护病房早期混合静脉氧饱和度与心脏指数相关性较差。","authors":"Petteri Holm, Jaana M Karhu, Tiina M Erkinaro, Pasi P Ohtonen, Janne H Liisanantti, Panu Taskinen, Hanna Säkkinen, Tero I Ala-Kokko, Timo I Kaakinen","doi":"10.1053/j.jvca.2025.04.030","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Our aim was to assess the association between mixed venous oxygen saturation (SvO<sub>2</sub>) and cardiac index (CI) among cardiac surgical patients during the initial 4 hours in the intensive care unit (ICU).</p><p><strong>Design: </strong>A single-center retrospective observational study.</p><p><strong>Setting: </strong>A tertiary-level university hospital.</p><p><strong>Participants: </strong>Adult cardiac surgical patients (N = 4,958) operated on during 2007 to 2020.</p><p><strong>Interventions: </strong>Pulmonary artery catheter (PAC) measurements of SvO<sub>2</sub> and CI were taken at ICU admission and 4 hours later. Linear regression was used to analyze the association between these variables.</p><p><strong>Measurements and main results: </strong>Paired CI and SvO<sub>2</sub> values were available from 4,958 patients. The median (interquartile range) SvO<sub>2</sub> was 68% (63-72%) at ICU admission and 66% (61-71%) 4 hours later. CI was 2.34 L/min/m<sup>2</sup> (2.03-2.79) at ICU admission and 2.48 L/min/m<sup>2</sup> (2.15-2.86) 4 hours later. In the entire cohort, a 10% change of SvO<sub>2</sub> coincided with a CI change of 0.36 L/min/m<sup>2</sup> (95% confidence interval 0.34-0.38) at ICU admission and a change of 0.33 L/min/m<sup>2</sup> (0.31-0.36) at 4 hours. In patients with SvO<sub>2</sub> less than 60%, the association between CI and SvO<sub>2</sub> weakened further.</p><p><strong>Conclusions: </strong>Factors affecting oxygen consumption and demand weaken the association between SvO<sub>2</sub> and CI values in the early ICU recovery phase after cardiac surgery. Therefore, SvO<sub>2</sub> and CI values should not be relied upon in clinical decision-making as reliable predictors of one another.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mixed Venous Oxygen Saturation Has a Poor Association with Cardiac Index during Early Intensive Care Unit Stay after Cardiac Surgery.\",\"authors\":\"Petteri Holm, Jaana M Karhu, Tiina M Erkinaro, Pasi P Ohtonen, Janne H Liisanantti, Panu Taskinen, Hanna Säkkinen, Tero I Ala-Kokko, Timo I Kaakinen\",\"doi\":\"10.1053/j.jvca.2025.04.030\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Our aim was to assess the association between mixed venous oxygen saturation (SvO<sub>2</sub>) and cardiac index (CI) among cardiac surgical patients during the initial 4 hours in the intensive care unit (ICU).</p><p><strong>Design: </strong>A single-center retrospective observational study.</p><p><strong>Setting: </strong>A tertiary-level university hospital.</p><p><strong>Participants: </strong>Adult cardiac surgical patients (N = 4,958) operated on during 2007 to 2020.</p><p><strong>Interventions: </strong>Pulmonary artery catheter (PAC) measurements of SvO<sub>2</sub> and CI were taken at ICU admission and 4 hours later. Linear regression was used to analyze the association between these variables.</p><p><strong>Measurements and main results: </strong>Paired CI and SvO<sub>2</sub> values were available from 4,958 patients. The median (interquartile range) SvO<sub>2</sub> was 68% (63-72%) at ICU admission and 66% (61-71%) 4 hours later. CI was 2.34 L/min/m<sup>2</sup> (2.03-2.79) at ICU admission and 2.48 L/min/m<sup>2</sup> (2.15-2.86) 4 hours later. In the entire cohort, a 10% change of SvO<sub>2</sub> coincided with a CI change of 0.36 L/min/m<sup>2</sup> (95% confidence interval 0.34-0.38) at ICU admission and a change of 0.33 L/min/m<sup>2</sup> (0.31-0.36) at 4 hours. In patients with SvO<sub>2</sub> less than 60%, the association between CI and SvO<sub>2</sub> weakened further.</p><p><strong>Conclusions: </strong>Factors affecting oxygen consumption and demand weaken the association between SvO<sub>2</sub> and CI values in the early ICU recovery phase after cardiac surgery. Therefore, SvO<sub>2</sub> and CI values should not be relied upon in clinical decision-making as reliable predictors of one another.</p>\",\"PeriodicalId\":15176,\"journal\":{\"name\":\"Journal of cardiothoracic and vascular anesthesia\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-04-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cardiothoracic and vascular anesthesia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1053/j.jvca.2025.04.030\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiothoracic and vascular anesthesia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.jvca.2025.04.030","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Mixed Venous Oxygen Saturation Has a Poor Association with Cardiac Index during Early Intensive Care Unit Stay after Cardiac Surgery.
Objectives: Our aim was to assess the association between mixed venous oxygen saturation (SvO2) and cardiac index (CI) among cardiac surgical patients during the initial 4 hours in the intensive care unit (ICU).
Design: A single-center retrospective observational study.
Setting: A tertiary-level university hospital.
Participants: Adult cardiac surgical patients (N = 4,958) operated on during 2007 to 2020.
Interventions: Pulmonary artery catheter (PAC) measurements of SvO2 and CI were taken at ICU admission and 4 hours later. Linear regression was used to analyze the association between these variables.
Measurements and main results: Paired CI and SvO2 values were available from 4,958 patients. The median (interquartile range) SvO2 was 68% (63-72%) at ICU admission and 66% (61-71%) 4 hours later. CI was 2.34 L/min/m2 (2.03-2.79) at ICU admission and 2.48 L/min/m2 (2.15-2.86) 4 hours later. In the entire cohort, a 10% change of SvO2 coincided with a CI change of 0.36 L/min/m2 (95% confidence interval 0.34-0.38) at ICU admission and a change of 0.33 L/min/m2 (0.31-0.36) at 4 hours. In patients with SvO2 less than 60%, the association between CI and SvO2 weakened further.
Conclusions: Factors affecting oxygen consumption and demand weaken the association between SvO2 and CI values in the early ICU recovery phase after cardiac surgery. Therefore, SvO2 and CI values should not be relied upon in clinical decision-making as reliable predictors of one another.
期刊介绍：
The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.
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