Margreiter, J., Keller, C., and Brimacombe, J. (2002) The feasibility of transesophageal echocardiograph-guided right and left ventricular oximetry in hemodynamically stable patients undergoing coronary artery bypass grafting. Anesthesia and Analgesia, 94 (4). pp. 794-798.

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Abstract

There are no techniques available for continuous noninvasive measurement of the oxygen saturation of blood flowing through the heart. We assessed the feasibility and accuracy of transesophageal echocardiograph (TEE)-guided left ventricular (Spo₂ LV) and right ventricular (Spo₂ RV) oximetry. Twenty hemodynamically stable, well-oxygenated anesthetized patients (ASA physical status III, aged 51–75 yr) undergoing coronary artery bypass grafting were studied. A TEE probe was modified by attaching a single-use pediatric reflectance pulse oximeter just proximal to the ultrasound transducer. The TEE probe was directed toward the LV by using the transgastric mid-short axis view or toward the RV by using the transgastric RV inflow view, in random order. Readings were taken every 30 s for 10 min during a hemodynamically stable period of anesthesia. Simultaneous blood samples were taken from the radial artery and pulmonary artery to determine arterial oxygen saturation (Sao₂) and mixed venous oxygen saturation (Svo₂), respectively. During Spo₂ LV readings, simultaneous finger pulse oximetry (Spo₂ finger) was also recorded. Spo₂ LV was feasible in 20 of 20 patients, and Spo₂ RV was feasible in 19 of 20 patients. The mean ± sd (range) oxygen saturation for each method was the following: Spo2 LV, 98.7% ± 0.6% (97%–100%); Sao2, 98.7% ± 0.6% (96.6%–99.4%); Spo2 finger, 98.1% ± 1.2% (97%–100%); Spo2 RV, 73.9% ± 4.7% (64%–85%); and Svo2, 74.5% ± 4.4% (66.8%–82.6%). Spo2 LV agreed closely with Sao₂ (mean difference, 0.072%). Spo₂ RV agreed closely with Svo₂ (mean difference, 0.65%). Spo₂ LV agreed more closely with Sao₂ than finger oximetry (mean difference, −0.072 vs −0.692). TEE-guided Spo₂ LV and Spo₂ RV are feasible in hemodynamically stable anesthetized patients and provide similar readings to arterial and mixed venous blood samples. The technique merits further investigation.

Item ID:	27191
Item Type:	Article (Research - C1)
ISSN:	1526-7598
Date Deposited:	24 May 2013 05:57
FoR Codes:	11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110301 Anaesthesiology @ 100%
SEO Codes:	92 HEALTH > 9299 Other Health > 929999 Health not elsewhere classified @ 100%
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