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Accuracy of central venous oxygen saturation with a fiberoptic catheter

Introduction

Central venous oxygen saturation (ScvO2) can reflect the overall balance between the systemic oxygen delivery and supply. Several recent studies reported the importance of ScvO2 monitoring in critically ill patients. Recently, ScvO2 monitoring with fiberoptic catheters has been made available. The aim of this study was to evaluate the correlation between the ScvO2 values obtained by a fiberoptic catheter (CeVOX; Seda, Milan, Italy) and those measured with a CO-oximeter (GEM 4000; Instrumentation Laboratory Milan, Italy).

Methods

After in vivo calibration of the fiberoptic catheter, blood samples were collected at intervals of no more than 12 hours. Twenty-nine critically ill patients from different aetiologies (septic shock, acute lung injury/acute respiratory distress syndrome pneumonia, pancreatitis, trauma), 21 male, with a mean age of 59.8 ± 17.7 years, mean weight 78.6 ± 10.0 kg and mean Simplified Acute Physiology Score of 39 ± 14 were enrolled.

Results

One hundred and nineteen samples were collected. The measured with the fiberoptic catheter showed a weak ScvO2 correlation (r2 = 0.46) with the CO-oximeter. The mean bias (average difference between catheter readings and CO-oximeter values), precision (standard deviation of the bias) and limits of agreement (bias ± 2 SD of bias) were -0.17, 4.7 and -0.17 ± 9.4 respectively (Figure 1).

Figure 1
figure1

Plot of the mean ScvO 2 values versus their difference by the Bland–Altman method.

Conclusion

Considering the absolute value, the fiberoptic catheter, after 12 hours of usage without any further calibration, presented a weak accuracy. To improve the clinical management we suggest performing in vivo calibration more frequently.

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Chiumello, D., Berto, V., Mietto, C. et al. Accuracy of central venous oxygen saturation with a fiberoptic catheter. Crit Care 13, P234 (2009). https://doi.org/10.1186/cc7398

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Keywords

  • Catheter
  • Pneumonia
  • Pancreatitis
  • Septic Shock
  • Respiratory Distress