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Continuous cardiac output and mixed venous oxygen saturation monitoring

Journal of Critical Care
Publication Date
DOI: 10.1016/s0883-9441(98)90006-5
  • Design
  • Medicine


Abstract Continuous assessment of cardiac output and Svo 2 in the critically ill may be helpful in both the monitoring variations in the patient's cardiovascular state and in determining the efficacy of therapy. Commercially available continuous cardiac output (CCO) monitoring systems are based on the pulsed warm thermodilution technique. In vitro validation studies have demonstrated that this method provides higher accuracy and greater resistance to thermal noise than standard bolus thermodilution techniques. Numerous clinical studies comparing bolus with continuous thermodilution techniques have shown this technique similarly accurate to track each other and to have negligible bias between them. The comparison between continuous thermal and other cardiac output methods also demonstrates good precision of the continuous thermal technique. Accuracy of continuous oximetry monitoring using reflectance oximetry via fiberoptics has been assessed both in vitro and in vivo. Most of the studies testing agreement between continuous Svo 2 measurements and pulmonary arterial blood samples measured by standard oximetry have shown good correlation. Continuous Svo 2 monitoring is often used in the management of critically ill patients. The most recently designed pulmonary artery catheters are now able to simultaneously measure either Svo 2 and CCO or Svo 2 and right ventricular ejection fraction. This ability to view simultaneous trends of Svo 2 and right ventricular performance parameters will probably allow the clinician to graphically see the impact of volume loading or inotropic therapy over time, as well as the influence of multiple factors, including right ventricular dysfunction, on Svo 2. However, the cost-effectiveness of new pulmonary artery catheters application remains still questionable because no established utility or therapeutic guidelines are available.

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