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TECHNOLOGY, COMPUTING, AND SIMULATION

A Pilot Study of Continuous Transtracheal Mixed Venous Oxygen Saturation Monitoring

Departments of Anesthesiology and Cardiothoracic Surgery, West China Hospital, Sichuan University; Department of Physics, Sichuan University, Chengdu, Sichuan, P. R. China; and the Department of Anesthesia, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, P. R. China.

Address correspondence and reprint requests to Jin Liu, MD, Department of Anesthesiology, West China Hospital, Sichuan University. No 37, Guo-xue-xiang, Chengdu, Sichuan 610041, P. R. China. Address e-mail to wuliujin{at}china.com.

In this study, we investigated the feasibility and the accuracy of transtracheal mixed venous oxygen saturation (Svo₂) monitoring. Ten patients undergoing thoracic surgery were included in this study. A single-use pediatric pulse oximetry sensor was attached to the double-lumen tube between the tracheal and bronchial cuff. After anesthesia was induced, the double-lumen tube was inserted into the trachea and adjusted to the proper position. During surgery, the pulmonary arterial blood was sampled every 3 min for 15 min to measure the Svo₂. The measurements made by the transtracheal pulmonary pulse oximeter (Sto₂) were recorded at the same time that blood was sampled from the pulmonary artery for Svo₂ measurements. The levels of measurement agreement between the Sto₂ and the Svo₂ were analyzed using the Bland and Altman method. The mean ± sd (range) oxygen saturation values during the data collecting period were 82.0% ± 4.9% (72%–91%) for the Sto₂ and 82.2% ± 5.5% (71%–91%) for the Svo₂, respectively. The linear correlation coefficient of the regression analysis between the Sto₂ and the Svo₂ was 0.934 (P < 0.05). A 95% confidence interval for absolute difference between the Sto₂ and the Svo₂ was 1.58%–2.09%. The mean ± 2 sd difference between the Sto₂ and the Svo₂ was 0.12% ± 3.97% on the Bland and Altman graph. We conclude that it is feasible to monitor the pulmonary artery oxygen saturation continuously by a transtracheal pulse oximetry technique and that it can be done so accurately.

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