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The monitoring of venous saturations of oxygen in children with congenitally malformed hearts

Published online by Cambridge University Press:  20 January 2009

Jeff Martin  and
Lara S. Shekerdemian
Jeff Martin*
Affiliation:
Department of Paediatric Intensive Care, Birmingham Children’s Hospital NHS Trust, Steelhouse Lane, Birmingham, United Kingdom
Lara S. Shekerdemian
Affiliation:
Department of Paediatric Intensive Care, Royal Children’s Hospital, Melbourne, Australia
*
Correspondence to: Jeff Martin, Paediatric Intensive Care Unit, Birmingham Children’s Hospital NHS Trust, Steelhouse Lane, Birmingham, B4 6NH, United Kingdom. Tel: 00 44 121 333 9652; Fax: 00 44 121 333 9651; E-mail: marttup@hotmail.com
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Abstract

Mixed venous saturation of oxygen has for some time been used as a tool to assess the adequacy of systemic delivery of oxygen in intensive care. In the post-operative child with cardiac disease, it is increasingly being used to assess adequacy of cardiac output. In many of these patients, true sampling of mixed venous saturation of oxygen is not possible due to the infrequent use of pulmonary arterial catheters, or the presence of intra-cardiac left to right shunting leading to mixing of systemic and pulmonary venous blood. The use of saturation of oxygen in the central venous blood as a surrogate for mixed venous saturation of oxygen has been widely investigated in adults, but its use remains controversial. In this review, we discuss the theory behind the use of mixed venous saturation of oxygen in evaluating cardiac output, the problems pertinent to those patients with congenitally malformed hearts, and explore the evidence for central venous saturation of oxygen as a surrogate for mixed venous saturation of oxygen, and its use as a therapeutic target to improve outcomes in this population of patients.

Keywords

Venous oxyhaemoglobin saturationoxygen consumptionheart defectscongenitalhypoplastic left heart syndromeanaerobic threshold
Type
Review Article
Information
Cardiology in the Young , Volume 19 , Issue 1 , February 2009 , pp. 34 - 39
Copyright
Copyright © Cambridge University Press 2009

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