Comparison of calculated and measured mixed venous oxygen saturation in critically ill patients.

G Cieslinski, T Konrad, H Klepzig
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Abstract

Objective: According to the Fick principle the calculation of cardiac output and shunts is based on the exact determination of oxygen saturation. In this study an intraindividual comparison of two frequently applied methods was done.

Design and setting: The calculated saturation by measuring partial oxygen pressure was compared with a gold standard, the reflectometrically measured saturation.

Patients: 75 patients of an intensive care unit in whom a Swan-Ganz catheter was introduced to answer clinical questions.

Results: Overall, most calculated values were higher than the measured ones, the mean difference was 5.9% (+/- 8.03%), ranging from -10.4 to +37%. In lower saturations (< 65%) the difference between both estimated values was larger than in the range above 65%.

Conclusions: Especially when handling with lower oxygen saturations, calculation of saturation with an automatic gas analyzer leads to overestimated values. The Fick principle can only be applied for hemodynamic calculations when oxygen saturation can be determined by an easy and correct method.

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危重病人混合静脉血氧饱和度计算与测量的比较。
目的:根据菲克原理,在准确测定血氧饱和度的基础上计算心输出量和分流量。在这项研究中,对两种常用的方法进行了个体比较。设计与设定:通过测量氧分压计算出的饱和度与金标准——反射法测量的饱和度进行比较。患者:重症监护病房的75例患者,其中引入Swan-Ganz导管以回答临床问题。结果:总体而言,大多数计算值高于实测值,平均差值为5.9%(+/- 8.03%),范围为-10.4 ~ +37%。在较低饱和度(< 65%)下,两个估计值之间的差异大于高于65%的范围。结论:特别是在处理低氧饱和度时,用自动气体分析仪计算饱和度会导致高估值。只有当氧饱和度可以用一种简单而正确的方法确定时,菲克原理才能应用于血流动力学计算。
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