Abstract

BANILLE, Edgardo et al. Saturación venosa central de oxígeno: Su valor en el monitoreo cardiovascular pediátrico. Arch. argent. pediatr. [online]. 2006, vol.104, n.5, pp.406-411. ISSN 0325-0075.

Introduction. Cardiac output might be evaluated clinically or measured by studies which have several limitations. Central venous oxygen saturation is a subrogate indicator of cardiac output. The purpose of this study was to evaluate the usefulness of central venous oxygen saturation monitoring during the postoperative period of pediatric heart surgery. Population, material and methods. This was a retrospective- observational study that included 70 patients operated on between 1998-2001. During admission at intensive care unit they were classified in 4 groups according to their heart output according to heart rate, mean arterial pressure, urine output, pulse and temperature as: stable (I), low heart output (II), moderately low (III) and severely low (IV). Treatment was started according to the severity of decreased heart output. Arterial and venous blood gases were regularly obtained. Results. Age was 18 (5.5-29.2) months. Cardiopulmonary bypass and aortic cross clamping times were longer in groups II, III and IV compared with I (p = 0.03). Variables obtained at 24 hours showed significant differences in: central venous oxygen saturation (I: 73.8%; II: 69%; III: 63%; IV: 59%) (p <0.001; <0.001 and 0.03 comparing I-II, II-III, III-IV); higher temperature and heart rate for groups II, III and IV compared with I (p = 0.008 and 0.001, respectively); higher doses of dopamine, epinephrine and milrinone were required for patients in poorer condition. There were no statistical differences in hematocrit, oxygen arterial saturation and mean arterial pressure. Conclusion. After 24 hours of postoperative period, in spite of normalization of hematocrit, mean arterial pressure and arterial oxygen saturation, lower central venous oxygen saturation values shown in the groups III and IV, would indicate an abnormality in tissue oxigenation due to low heart output in the initially sicker patients.

Keywords : Venous oxygen saturation; Heart output; Heart surgery monitoring.

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