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The PediaSat continuous central SvO2 monitoring system does not reliably indicate state or course of central venous oxygenation.

Abstract：

BACKGROUND AND OBJECTIVE:The present study compares the accuracy of a new continuous venous oxygenation monitoring system (PediaSat Oximetry Catheter) with laboratory blood oximetry in paediatric surgical patients. METHODS:Children and adolescents undergoing cardiac, orthopaedic or craniofacial surgery with major blood loss were included. A 4.5 Fr two-lumen or 5.5 Fr three-lumen central venous oximetry catheter (SPediaSatcvO2) was inserted preoperatively into the superior vena cava. After in-vivo calibration of the PediaSat system, repeated blood samples were obtained from the distal port of the venous catheter and oximetrically analysed for haemoglobin and central venous oxygen saturation (SCO-OXcvO2). Central venous oxygen saturation values measured by the PediaSat (SPediaSatcvO2) were compared with co-oximetry (SCO-OXcvO2) values from the simultaneously taken blood samples by Bland-Altman and simple regression analyses. RESULTS:Overall, 142 data pairs from 27 patients, aged from 0.6 to 19.0 years (median 5.3 years) were analysed. SPediaSatcvO2 and SCO-OXcvO2 values ranged from 57 to 98% and from 57.1 to 95.8%, respectively. Correlation between SPediaSatcvO2 and SCO-OXcvO2 was poor with r equal to 0.28 (P < 0.0001). SPediaSatcvO2 overestimated SCO-OXcvO2 (mean bias +2.6%), but limits of agreement (+/-2 SD of bias) were unacceptably high (-14.4/+19.6%). Sensitivity and specificity of SPediaSatcvO2 to indicate a fall or rise of SCO-OXcvO2 between two subsequent measurements were only 0.42 and 0.24, respectively. CONCLUSION:In paediatric and adolescent patients undergoing major surgery, the PediaSat system did not reliably reflect SCO-OXcvO2 values and cannot replace repeated invasive ScvO2 assessments in the clinically relevant range of ScvO2.

journal_name

Eur J Anaesthesiol

journal_title

European journal of anaesthesiology

authors

Baulig W,Béttex D,Bürki C,Schmitz A,Spielmann N,Woitzek K,Weiss M

doi

10.1097/EJA.0b013e32833bf5c5

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

720-5

issue

eissn

0265-0215

issn

1365-2346

journal_volume

pub_type

临床试验,杂志文章

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The PediaSat continuous central SvO2 monitoring system does not reliably indicate state or course of central venous oxygenation.