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Blood Gas Analysis of Mixed Venous Blood During Normoxic Acute Isovolemic Hemodilution in Pigs

Department of Anesthesiology, Erasmus University Rotterdam, The Netherlands.

Abstract

Mixed venous oxygen saturation of hemoglobin (Svo₂) and mixed venous oxygen tension (Pvo₂) may reflect the overall balance between oxygen consumption and delivery. Because of the potential value of monitoring Svo₂ and Pvo₂ as indications of the state of tissue oxygenation, the aim of this study was to determine, during normoxic acute isovolemic hemodilution in pigs, the critical Pvo₂, critical Svo₂, and critical oxygen extraction ratio (ER) at which oxygen uptake starts to decline during further induced hemodilution.

During stepwise induced isovolemic hemodilution, a gradual decline in Svo₂ and Pvo₂ was observed in all animals. The mean ± SD of the critical Pvo₂ of six animals was 32.3 ±3.1 mm Hg. The mean ± SD of the critical Svo₂ was 44.2% ± 7.9%. The ER increased gradually. At an ER of 0.57 ± 0.08, oxygen uptake started to decline. A significant correlation was found between changes in Svo₂ and changes in ER. These degrees of hemodilution were accompanied by an increase in cardiac index, pulmonary wedge pressure, heart rate, and left ventrkular stroke work index. Only a slight decrease in systemic vascular resistance was observed. We conclude that measurements of Pvo₂ and Svo₂ can be used as indicators of the critical point of hemodilution and that the Svo₂ during hemodilution reflects the overall balance between oxygen uptake and oxygen delivery, confirmed by the strong correlation found between Svo₂ and oxygen extraction ratio.

Key Words: BLOOD, HEMODILUTION—isovolemic

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