Non-invasive capnodynamic mixed venous oxygen saturation during major changes in oxygen delivery
Mixed venous oxygen saturation (SvO 2 ) is an important variable in anesthesia and intensive care but currently requires pulmonary artery catheterization. Recently, non-invasive determination of SvO 2 (Capno-SvO 2 ) using capnodynamics has shown good agreement against CO-oximetry in an animal model...
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| Veröffentlicht in: | Journal of clinical monitoring and computing 2022-10, Vol.36 (5), p.1315-1324 |
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| creator | Svedmyr, Anders Konrad, Mark Wallin, Mats Hallbäck, Magnus Lönnqvist, Per-Arne Karlsson, Jacob |
| description | Mixed venous oxygen saturation (SvO
2
) is an important variable in anesthesia and intensive care but currently requires pulmonary artery catheterization. Recently, non-invasive determination of SvO
2
(Capno-SvO
2
) using capnodynamics has shown good agreement against CO-oximetry in an animal model of modest hemodynamic changes. The purpose of the current study was to validate Capno-SvO
2
against CO-oximetry during major alterations in oxygen delivery. Furthermore, evaluating fiberoptic SvO
2
for its response to the same challenges. Eleven mechanically ventilated pigs were exposed to oxygen delivery changes: increased inhaled oxygen concentration, hemorrhage, crystalloid and blood transfusion, preload reduction and dobutamine infusion. Capno-SvO
2
and fiberoptic SvO
2
recordings were made in parallel with CO-oximetry. Respiratory quotient, needed for capnodynamic SvO
2
, was measured by analysis of mixed expired gases. Agreement of absolute values between CO-oximetry and Capno-SvO
2
and fiberoptic SvO
2
respectively, was assessed using Bland–Altman plots. Ability of Capno- SvO
2
and fiberoptic SvO
2
to detect change compared to CO-oximetry was assessed using concordance analysis. The interventions caused significant hemodynamic variations. Bias between Capno-SvO
2
and CO-oximetry was + 3% points (95% limits of agreements – 7 to + 13). Bias between fiberoptic SvO
2
and CO-oximetry was + 1% point, (95% limits of agreements − 7 to + 9). Concordance rate for Capno-SvO
2
and fiberoptic SvO
2
vs. CO-oximetry was 98% and 93%, respectively. Capno-SvO
2
generates absolute values close to CO-oximetry. The performance of Capno-SvO
2
vs. CO-oximetry was comparable to the performance of fiberoptic SvO
2
vs. CO-oximetry. Capno-SvO
2
appears to be a promising tool for non-invasive SvO
2
monitoring. |
| doi_str_mv | 10.1007/s10877-021-00762-5 |
| format | Article |
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2
) is an important variable in anesthesia and intensive care but currently requires pulmonary artery catheterization. Recently, non-invasive determination of SvO
2
(Capno-SvO
2
) using capnodynamics has shown good agreement against CO-oximetry in an animal model of modest hemodynamic changes. The purpose of the current study was to validate Capno-SvO
2
against CO-oximetry during major alterations in oxygen delivery. Furthermore, evaluating fiberoptic SvO
2
for its response to the same challenges. Eleven mechanically ventilated pigs were exposed to oxygen delivery changes: increased inhaled oxygen concentration, hemorrhage, crystalloid and blood transfusion, preload reduction and dobutamine infusion. Capno-SvO
2
and fiberoptic SvO
2
recordings were made in parallel with CO-oximetry. Respiratory quotient, needed for capnodynamic SvO
2
, was measured by analysis of mixed expired gases. Agreement of absolute values between CO-oximetry and Capno-SvO
2
and fiberoptic SvO
2
respectively, was assessed using Bland–Altman plots. Ability of Capno- SvO
2
and fiberoptic SvO
2
to detect change compared to CO-oximetry was assessed using concordance analysis. The interventions caused significant hemodynamic variations. Bias between Capno-SvO
2
and CO-oximetry was + 3% points (95% limits of agreements – 7 to + 13). Bias between fiberoptic SvO
2
and CO-oximetry was + 1% point, (95% limits of agreements − 7 to + 9). Concordance rate for Capno-SvO
2
and fiberoptic SvO
2
vs. CO-oximetry was 98% and 93%, respectively. Capno-SvO
2
generates absolute values close to CO-oximetry. The performance of Capno-SvO
2
vs. CO-oximetry was comparable to the performance of fiberoptic SvO
2
vs. CO-oximetry. Capno-SvO
2
appears to be a promising tool for non-invasive SvO
2
monitoring.</description><identifier>ISSN: 1387-1307</identifier><identifier>EISSN: 1573-2614</identifier><identifier>DOI: 10.1007/s10877-021-00762-5</identifier><identifier>PMID: 34609659</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Anesthesia ; Anesthesiology ; Bias ; Blood transfusion ; Carbon monoxide ; Critical Care Medicine ; Health Sciences ; Hemodynamics ; Hemorrhage ; Intensive ; Medicine ; Medicine & Public Health ; Original Research ; Oximetry ; Oxygen ; Oxygen content ; Oxygen saturation ; Pulmonary arteries ; Statistics for Life Sciences</subject><ispartof>Journal of clinical monitoring and computing, 2022-10, Vol.36 (5), p.1315-1324</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-9d8ea965bb166036bebff362242cb4fee487a79cea9efba1a1856b818c1c55df3</citedby><cites>FETCH-LOGICAL-c489t-9d8ea965bb166036bebff362242cb4fee487a79cea9efba1a1856b818c1c55df3</cites><orcidid>0000-0002-7526-4751 ; 0000-0003-2277-0092 ; 0000-0001-5558-5104 ; 0000-0002-8586-1429</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10877-021-00762-5$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10877-021-00762-5$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:147833458$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Svedmyr, Anders</creatorcontrib><creatorcontrib>Konrad, Mark</creatorcontrib><creatorcontrib>Wallin, Mats</creatorcontrib><creatorcontrib>Hallbäck, Magnus</creatorcontrib><creatorcontrib>Lönnqvist, Per-Arne</creatorcontrib><creatorcontrib>Karlsson, Jacob</creatorcontrib><title>Non-invasive capnodynamic mixed venous oxygen saturation during major changes in oxygen delivery</title><title>Journal of clinical monitoring and computing</title><addtitle>J Clin Monit Comput</addtitle><description>Mixed venous oxygen saturation (SvO
2
) is an important variable in anesthesia and intensive care but currently requires pulmonary artery catheterization. Recently, non-invasive determination of SvO
2
(Capno-SvO
2
) using capnodynamics has shown good agreement against CO-oximetry in an animal model of modest hemodynamic changes. The purpose of the current study was to validate Capno-SvO
2
against CO-oximetry during major alterations in oxygen delivery. Furthermore, evaluating fiberoptic SvO
2
for its response to the same challenges. Eleven mechanically ventilated pigs were exposed to oxygen delivery changes: increased inhaled oxygen concentration, hemorrhage, crystalloid and blood transfusion, preload reduction and dobutamine infusion. Capno-SvO
2
and fiberoptic SvO
2
recordings were made in parallel with CO-oximetry. Respiratory quotient, needed for capnodynamic SvO
2
, was measured by analysis of mixed expired gases. Agreement of absolute values between CO-oximetry and Capno-SvO
2
and fiberoptic SvO
2
respectively, was assessed using Bland–Altman plots. Ability of Capno- SvO
2
and fiberoptic SvO
2
to detect change compared to CO-oximetry was assessed using concordance analysis. The interventions caused significant hemodynamic variations. Bias between Capno-SvO
2
and CO-oximetry was + 3% points (95% limits of agreements – 7 to + 13). Bias between fiberoptic SvO
2
and CO-oximetry was + 1% point, (95% limits of agreements − 7 to + 9). Concordance rate for Capno-SvO
2
and fiberoptic SvO
2
vs. CO-oximetry was 98% and 93%, respectively. Capno-SvO
2
generates absolute values close to CO-oximetry. The performance of Capno-SvO
2
vs. CO-oximetry was comparable to the performance of fiberoptic SvO
2
vs. CO-oximetry. Capno-SvO
2
appears to be a promising tool for non-invasive SvO
2
monitoring.</description><subject>Anesthesia</subject><subject>Anesthesiology</subject><subject>Bias</subject><subject>Blood transfusion</subject><subject>Carbon monoxide</subject><subject>Critical Care Medicine</subject><subject>Health Sciences</subject><subject>Hemodynamics</subject><subject>Hemorrhage</subject><subject>Intensive</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Research</subject><subject>Oximetry</subject><subject>Oxygen</subject><subject>Oxygen content</subject><subject>Oxygen saturation</subject><subject>Pulmonary arteries</subject><subject>Statistics for Life 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Magnus</au><au>Lönnqvist, Per-Arne</au><au>Karlsson, Jacob</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Non-invasive capnodynamic mixed venous oxygen saturation during major changes in oxygen delivery</atitle><jtitle>Journal of clinical monitoring and computing</jtitle><stitle>J Clin Monit Comput</stitle><date>2022-10-01</date><risdate>2022</risdate><volume>36</volume><issue>5</issue><spage>1315</spage><epage>1324</epage><pages>1315-1324</pages><issn>1387-1307</issn><eissn>1573-2614</eissn><abstract>Mixed venous oxygen saturation (SvO
2
) is an important variable in anesthesia and intensive care but currently requires pulmonary artery catheterization. Recently, non-invasive determination of SvO
2
(Capno-SvO
2
) using capnodynamics has shown good agreement against CO-oximetry in an animal model of modest hemodynamic changes. The purpose of the current study was to validate Capno-SvO
2
against CO-oximetry during major alterations in oxygen delivery. Furthermore, evaluating fiberoptic SvO
2
for its response to the same challenges. Eleven mechanically ventilated pigs were exposed to oxygen delivery changes: increased inhaled oxygen concentration, hemorrhage, crystalloid and blood transfusion, preload reduction and dobutamine infusion. Capno-SvO
2
and fiberoptic SvO
2
recordings were made in parallel with CO-oximetry. Respiratory quotient, needed for capnodynamic SvO
2
, was measured by analysis of mixed expired gases. Agreement of absolute values between CO-oximetry and Capno-SvO
2
and fiberoptic SvO
2
respectively, was assessed using Bland–Altman plots. Ability of Capno- SvO
2
and fiberoptic SvO
2
to detect change compared to CO-oximetry was assessed using concordance analysis. The interventions caused significant hemodynamic variations. Bias between Capno-SvO
2
and CO-oximetry was + 3% points (95% limits of agreements – 7 to + 13). Bias between fiberoptic SvO
2
and CO-oximetry was + 1% point, (95% limits of agreements − 7 to + 9). Concordance rate for Capno-SvO
2
and fiberoptic SvO
2
vs. CO-oximetry was 98% and 93%, respectively. Capno-SvO
2
generates absolute values close to CO-oximetry. The performance of Capno-SvO
2
vs. CO-oximetry was comparable to the performance of fiberoptic SvO
2
vs. CO-oximetry. Capno-SvO
2
appears to be a promising tool for non-invasive SvO
2
monitoring.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>34609659</pmid><doi>10.1007/s10877-021-00762-5</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7526-4751</orcidid><orcidid>https://orcid.org/0000-0003-2277-0092</orcidid><orcidid>https://orcid.org/0000-0001-5558-5104</orcidid><orcidid>https://orcid.org/0000-0002-8586-1429</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1387-1307 |
| ispartof | Journal of clinical monitoring and computing, 2022-10, Vol.36 (5), p.1315-1324 |
| issn | 1387-1307 1573-2614 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_458545 |
| source | SpringerLink Journals; SWEPUB Freely available online |
| subjects | Anesthesia Anesthesiology Bias Blood transfusion Carbon monoxide Critical Care Medicine Health Sciences Hemodynamics Hemorrhage Intensive Medicine Medicine & Public Health Original Research Oximetry Oxygen Oxygen content Oxygen saturation Pulmonary arteries Statistics for Life Sciences |
| title | Non-invasive capnodynamic mixed venous oxygen saturation during major changes in oxygen delivery |
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