Différence artérioveineuse du contenu en O2, saturation veineuse mêlée en O2 ou index cardiaque en postopératoire de chirurgie cardiaque : sont-ils équivalents ?

Abstract: Objective: To study the concordance of cardiac index (CI), mixed venous oxygen saturation (SvO2) and the arterial-mixed venous O2 content difference, i.e.: C(a–v)O2, postoperatively to cardiac surgery. We hypothesized that significant discrepancies would be measurable between C(a–v)O2 and SvO2, and CI, because the latter two indices encompass less metabolic components than the former. Design: Analysis of variables collected as part of routine care. Patients: Eighty anesthetized patients receiving mechanical ventilation after heart surgery. Measurements and results: Using linear regression of SvO2 versus C(a–v)O2 (Reg 1) and CI versus C(a–v)O2 (Reg 2), respectively we found that CI=2.2Lmin−1 m−2 and SvO2 =70% were equivalent to C(a–v)O2 =5ml/100ml. The error reflected by the vertical scatter of points around the regression line, once normalized was 3.24 times greater in Reg 2 than in Reg 1. Conclusions: The correspondence of CI, SvO2 and C(a–v)O2 values observed in a population of patients studied immediately after scheduled heart surgery match those reported in critically ill patients. SvO2 and furthermore CI induced a sizeable scatter of points around regression line. Accordingly, they appear as a lesser estimate of the flow/metabolism balance that may at best be inferred from C(a–v)O2. [Copyright &y& Elsevier]