Skip to main content
SpringerLink
Log in

SvO2/ScvO2

  • Chapter
Hemodynamic Monitoring

Part of the book series: Lessons from the ICU ((LEICU))

  • 4158 Accesses

Abstract

Physical examination plays a very important role in the evaluation of critically ill patients. Certain features such as skin color, capillary refill, mentation, urine output, and pulse quality can tell us a lot about the patient’s hemodynamic status. However, some very important features remain hidden even from the most experienced observer or become obvious only at their extremes. These are bicarbonate and lactate levels, hydrogen ion concentrations (i.e., pH), and the balance between oxygen delivery and consumption. Although for detailed monitoring invasive hemodynamic measurements are required, these are not available in every patient. However, arterial and central venous catheters are part of routine monitoring of the intensive care patient, and a simple blood gas measurement can reveal important physiological processes, which cannot be detected otherwise. In the coming chapter, we are going to discuss the rationale and clinical implication of the venous oxygen saturation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Velissaris D, Pierrakos C, Scolletta S, Backer D, Vincent JL. High mixed venous oxygen saturation levels do not exclude fluid responsiveness in critically ill septic patients. Crit Care. 2011;15:R177.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Weil MH, Rackow EC, Trevino R, Grundler W, Falk JL, Griffel MI. Difference in acid-base state between venous and arterial blood during cardiopulmonary resuscitation. N Engl J Med. 1986;315:153–6.

    Article  CAS  PubMed  Google Scholar 

  3. Møller MH, Cecconi M. Venous-to-arterial carbon dioxide difference: an experimental model or a bedside clinical tool? Intensive Care Med. 2016;42:287–9.

    Article  PubMed  Google Scholar 

  4. Evans DC, Doraiswamy VA, Prosciak MP, Silviera M, Seamon MJ, Rodriguez Funes V, et al. Complications associated with pulmonary artery catheters: a comprehensive clinical review. Scand J Surg. 2009;98:199–208.

    Article  CAS  PubMed  Google Scholar 

  5. Dueck MH, Klimek M, Appenrodt S, Weigand C, Boerner U. Trends but not individual values of central venous oxygen saturation agree with mixed venous oxygen saturation during varying hemodynamic conditions. Anesthesiology. 2005;103:249–57.

    Article  PubMed  Google Scholar 

  6. Reinhart K, Kuhn HJ, Hartog C, Bredle DL. Continuous central venous and pulmonary artery oxygen saturation monitoring in the critically ill. Intensive Care Med. 2004;30:1572–8.

    Article  PubMed  Google Scholar 

  7. Reinhart K, Rudolph T, Bredle DL, Hannemann L, Cain SM. Comparison of central-venous to mixed-venous oxygen saturation during changes in oxygen supply/demand. Chest. 1989;95:1216–21.

    Article  CAS  PubMed  Google Scholar 

  8. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315:801–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368–77.

    Article  CAS  Google Scholar 

  10. Trzeciak S, Dellinger RP, Abate NL, Cowan RM, Stauss M, Kilgannon JH, et al. Translating research to clinical practice: a 1-year experience with implementing early goal-directed therapy for septic shock in the emergency department. Chest. 2006;129:225–32.

    Article  PubMed  Google Scholar 

  11. Jones AE, Shapiro NI, Roshon M. Implementing early goal-directed therapy in the emergency setting: the challenges and experiences of translating research innovations into clinical reality in academic and community settings. Acad Emerg Med. 2007;14:1072–8.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rhodes A, Phillips G, Beale R, Cecconi M, Chiche JD, De Backer D, et al. The surviving sepsis campaign bundles and outcome: results from the International Multicentre Prevalence Study on Sepsis (the IMPreSS study). Intensive Care Med. 2015;41:1620–8.

    Article  PubMed  Google Scholar 

  13. ProCESS Investigators, Yealy DM, Kellum JA, Huang DT, Barnato AE, Weissfeld LA, et al. A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014;370:1683–93.

    Article  Google Scholar 

  14. ARISE Investigators, ANZICS Clinical Trials Group, Peake SL, Delaney A, Bailey M, Bellomo R, et al. Goal-directed resuscitation for patients with early septic shock. N Engl J Med. 2014;371:1496–506.

    Article  Google Scholar 

  15. Pope JV, Jones AE, Gaieski DF, Arnold RC, Trzeciak S, Shapiro NI, Emergency Medicine Shock Research Network (EMShockNet) Investigators. Multicenter study of central venous oxygen saturation (ScvO2) as a predictor of mortality in patients with sepsis. Ann Emerg Med. 2010;55:40–6.

    Article  PubMed  Google Scholar 

  16. Ince C, Sinaasappel M. Microcirculatory oxygenation and shunting in sepsis and shock. Crit Care Med. 1999;27:1369–77.

    Article  CAS  PubMed  Google Scholar 

  17. Du W, Liu DW, Wang XT, Long Y, Chai WZ, Zhou X, et al. Combining central venous-to-arterial partial pressure of carbon dioxide difference and central venous oxygen saturation to guide resuscitation in septic shock. J Crit Care. 2013;28:1110.

    Article  PubMed  Google Scholar 

  18. Muir AL, Kirby BJ, King AJ, Miller HC. Mixed venous oxygen saturation in relation to cardiac output in myocardial infarction. Br Med J. 1970;4:276–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Goldman RH, Braniff B, Harrison DC, Spivack AP. The use of central venous oxygen saturation measurements in a coronary care unit. Ann Intern Med. 1968;68:1280–7.

    Article  CAS  PubMed  Google Scholar 

  20. Creamer JE, Edwards JD, Nightingale P. Hemodynamic and oxygen transport variables in cardiogenic shock secondary to acute myocardial infarction, and response to treatment. Am J Cardiol. 1990;65:1297–300.

    Article  CAS  Google Scholar 

  21. Hsin HT, Chen LY, Lin PC, Shieh JS, Ao CV. Central venous oxygen saturation (ScVO2) facilitates the weaning of intra-aortic balloon pump in acute heart failure related to acute myocardial infarction. Int J Cardiol. 2013;168:4568–70.

    Article  PubMed  Google Scholar 

  22. Gallet R, Lellouche N, Mitchell-Heggs L, Bouhemad B, Bensaid A, Dubois-Randé JL, et al. Prognosis value of central venous oxygen saturation in acute decompensated heart failure. Arch Cardiovasc Dis. 2012;105:5–12.

    Article  PubMed  Google Scholar 

  23. Teixeira C, da Silva NB, Savi A, Vieira SR, Nasi LA, Friedman G, et al. Central venous saturation is a predictor of reintubation in difficult-to-wean patients. Crit Care Med. 2010;38:491–6.

    Article  PubMed  Google Scholar 

  24. Luciano Gattinoni MD, Davide Chiumello MD. Anemia in the intensive care unit: how big is the problem? Transfusion Alternatives Transfusion Med. 2002;4:118–20.

    Article  Google Scholar 

  25. Hébert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med. 1999;340:409–17.

    Article  PubMed  Google Scholar 

  26. Holst LB, Haase N, Wetterslev J, Wernerman J, Guttormsen AB, Karlsson S, et al. Lower versus higher hemoglobin threshold for transfusion in septic shock. N Engl J Med. 2014;371:1381–91.

    Article  PubMed  Google Scholar 

  27. Collaborative Study Group on Perioperative ScvO2 Monitoring. Multicentre study on peri- and postoperative central venous oxygen saturation in high-risk surgical patients. Crit Care. 2006;10:R158.

    Article  PubMed Central  Google Scholar 

  28. Pearse R, Dawson D, Fawcett J, Rhodes A, Grounds RM, Bennett ED. Changes in central venous saturation after major surgery, and association with outcome. Crit Care. 2005;9:R694–9.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Weiskopf RB, Viele MK, Feiner J, Kelley S, Lieberman J, Noorani M, et al. Human cardiovascular and metabolic response to acute, severe isovolemic anemia. JAMA. 1998;279:217–21.

    Article  CAS  PubMed  Google Scholar 

  30. Kobayashi M, Ko M, Irinoda T, Meguro E, Hayakawa Y, et al. Clinical usefulness of continuous central venous oxygen saturation measurement for postoperative management of patients following transthoracic esophagectomy for carcinoma. Esophagus. 2011;8:53–8.

    Article  Google Scholar 

  31. Kocsi S, Demeter G, Fogas J, Erces D, Kaszaki J, Molnar Z. Central venous oxygen saturation is a good indicator of altered oxygen balance in isovolemic anemia. Acta Anaesthesiol Scand. 2012;56:291–7.

    Article  CAS  PubMed  Google Scholar 

  32. Mikor A, Trasy D, Nemeth MF, Osztroluczki A, Kocsi S, Kovacs I, et al. Continuous central venous oxygen saturation assisted intraoperative hemodynamic management during major abdominal surgery: a randomized, controlled trial. BMC Anesthesiol. 2015;15:82.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Nemeth M, Tanczos K, Demeter G, Erces D, Kaszaki J, Mikor A, et al. Central venous oxygen saturation and carbon dioxide gap as resuscitation targets in a hemorrhagic shock. Acta Anaesthesiol Scand. 2014;58:611–9.

    Article  CAS  PubMed  Google Scholar 

  34. Cecconi M, Corredor C, Arulkumaran N, Abuella G, Ball J, Grounds RM, et al. Clinical review: goal-directed therapy-what is the evidence in surgical patients? The effect on different risk groups. Crit Care. 2013;17:209.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Molnar Z, Szabo Z, Nemeth M. Multimodal individualized concept of hemodynamic monitoring. Curr Opin Anaesthesiol. 2017;30:171–7.

    Article  PubMed  Google Scholar 

  36. Legrand M, Vallée F, Mateo J, Payen D. Influence of arterial dissolved oxygen level on venous oxygen saturation: don’t forget the PaO2! Shock. 2014;41:510–3.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary

    Zsolt Molnar & Marton Nemeth

Authors
  1. Zsolt Molnar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marton Nemeth
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Critical Care Medicine Dept., University of Pittsburgh, Pittsburgh, PA, USA

    Michael R. Pinsky

  2. Bicetre University Hospital, Paris South University, Le Kremlin-Bicêtre, France

    Jean-Louis Teboul

  3. Department of Intensive Care, Erasme University Hospital, Brussels, Belgium

    Jean-Louis Vincent

Rights and permissions

Reprints and permissions

Copyright information

© 2019 European Society of Intensive Care Medicine

About this chapter

Cite this chapter

Molnar, Z., Nemeth, M. (2019). SvO2/ScvO2. In: Pinsky, M.R., Teboul, JL., Vincent, JL. (eds) Hemodynamic Monitoring. Lessons from the ICU. Springer, Cham. https://doi.org/10.1007/978-3-319-69269-2_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-69269-2_15

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-69268-5

  • Online ISBN: 978-3-319-69269-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation