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Eur J Cardiothorac Surg 1999;16:450-457
© 1999 Elsevier Science NL

Routine SvO₂ measurement after CABG surgery with a surgically introduced pulmonary artery catheter

^a Department of Cardiothoracic Surgery, Linköping Heart Center, University Hospital, S-581 85 Linköping, Sweden
^b Department of Cardiothoracic Anesthesia, Linköping Heart Center, University Hospital, Linköping, Sweden

Corresponding author. Tel.: + 46-13-22-2000; fax: + 46-13-10-02-46
e-mail: rolf.svedjeholm{at}lio.se

Objective: It has been argued that the poor correlation between cardiac output and mixed venous oxygen saturation (SvO₂) reduces the value of SvO₂. Routine use of Swan Ganz catheters is also controversial in cardiac surgery. Here our clinical experience with a simplified method for routine hemodynamic monitoring and the short-term prognostic value of SvO₂ after CABG surgery is presented. Method: Peroperatively an epidural catheter is routinely introduced through the outflow tract of the right ventricle into the pulmonary artery for monitoring of pressure and blood sampling. Clinical data were retrospectively retrieved from the records and related to SvO₂ routinely obtained on admission to the ICU after 488 CABG procedures. Results: Average SvO₂ on arrival to ICU was 67±7%. The SvO₂ value of 55% represented a cut off point below which a high incidence of complications were found. Outcome after 456 procedures with SvO₂55% compared with 32 procedures with SvO₂<55%: mortality 0 vs. 9.4% (P=0.0003), perioperative myocardial infarction 6.2 vs. 29% (P<0.0001), ventilator treatment 8.9±10.1 vs. 25.7±54.9 h (P=0.0074), ICU stay 1.4±1.2 vs. 2.1±1.7 days (P=0.0010). Conclusions: SvO₂ was of prognostic value and due to its specificity it seems particularly useful for telling which patients are unlikely to develop cardiorespiratory problems. Thus, this simple method for hemodynamic monitoring could contribute to cost containment as it seems that we can safely reserve Swan Ganz catheters for high-risk patients.

Key Words: Mixed venous oxygen saturation • Cardiac output • Postoperative care • Cardiac surgery • Coronary surgery • Monitoring • Prognosis • Risk stratification

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