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A nomogram to evaluate the arterial mixed venous oxygen saturation difference during cardiopulmonary bypass

F Cavaliere

Institute of Anaesthesiology and Intensive Care, Catholic University of the Sacred Heart, Rome

A nomogram providing the arterial mixed venous haemoglobin saturation difference (Sa-vO2) corresponding to normal oxygen consumption (VO2) during cardiopulmonary bypass (CPB) was produced. Normal VO2 during CPB (95.8 ± 20.1 ml/min/m2 at 37°C) was obtained from the literature. The nomogram computes the Sa-vO2 from the body surface, pump flow, blood haemoglobin and patient temperature; a table is also presented which supplies the Sa-vO2 ranges corresponding to VO2 mean ±1 and ±2SD. The nomogram was tested on 10 subjects undergoing CPB for myocardial revascularization. Sa-vO2 was determined by arterial and mixed venous blood oximetry 5, 20, and 35 min after the start of CPB. The measured Sa-vO2 was 27.1 ± 7.2% while Sa-vO2 obtained from the nomogram was 24.9 ± 4.0%, the difference was not statistically significant. Eighteen values (60%) were within the range corresponding to VO2 mean ±1SD. One value was lower than the Sa-vO2 value corresponding to VO2 mean - 2SD and was associated with the lowest value of blood haemoglobin. Two values were higher than the Sa-vO2 value corresponding to VO2 mean + 2SD and were associated with inadequate muscle relaxation. By comparing measured Sa-vO2 values with those obtained by the nomogram and the table, anaesthesiologists and perfusionists can easily detect patients presenting abnormally low or high VO2 values.

Perfusion, Vol. 13, No. 1, 45-51 (1998)
DOI: 10.1177/026765919801300106


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F. Cavaliere
Impaired carbon dioxide transport during and after cardiopulmonary bypass
Perfusion, September 1, 2000; 15(5): 433 - 439.
[Abstract] [PDF]