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CARDIOVASCULAR ANESTHESIA

Validity of Arterial and Mixed Venous Oxygen Saturation Measurements in a Canine Hemorrhage Model After Resuscitation with Varying Concentrations of Hemoglobin-Based Oxygen Carrier

Fedor Lurie, MD, PhD^*, Bernd Driessen, DVM, PhD, Jonathan S. Jahr, MD, Rashell Reynoso, and Robert A. Gunther, PhD^||

*John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii; School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Anesthesiology, UCLA, and King/Drew Medical Center, Los Angeles, California; University of California-Davis College of Letters and Science, Davis, California; and ||Department of Surgery, University of California-Davis, Davis, California

Address correspondence and reprint requests to J. S. Jahr, MD, UCLA Department of Anesthesiology, Box 951778, Los Angeles, CA 90095-1778. Address e-mail to jsjahr{at}mednet.ucla.edu

In this study, we evaluated the validity of saturation measurements in mixed venous and arterial blood during posthemorrhagic anemia and resuscitation with varying levels of hemoglobin-based oxygen carrier (Hemoglobin glutamer-200 [bovine]; Oxyglobin^® [Hb-200]). Nineteen anesthetized, splenectomized, mixed-breed dogs were anesthetized (two were excluded from the data because they did not survive the exsanguination, supporting the validity of the model). Their pulmonary arteries were cannulated with the Abbott QVUE Oximetrix 3 catheter. An 18-gauge catheter was placed in the femoral artery, and a reusable Nellcor probe was applied to the tongue. Mixed venous and arterial samples were drawn at baseline, after 40% hemorrhage (to keep arterial pressure at 50 mm Hg), and postresuscitation with 30 mL/kg of 6% hetastarch in lactated Ringer’s solution (n = 4), 10 mL/kg of Hb-200, 20 mL/kg of hetastarch (n = 6), 20 mL/kg of Hb-200, and 10 mL/kg of hetastarch (n = 7). Samples were compared with oxygen content from the LEXO2CON-K oxygen analyzer, and oxygen content was calculated for all values from the monitors. Results were compared by using analysis of variance. There was good correlation (0.97 r 0.92) for the measured versus calculated hemoglobin oxygen saturation values at baseline. After resuscitation, the correlation between calculated and measured values of oxygen content was significantly smaller for all tested instruments. The values of oxygen content calculated from the oxygen saturation monitor and from the oximetric pulmonary artery can deviate by as much as 20% from directly measured values. We conclude that the administration of this oxygen therapeutic may interfere with the values of some monitors.

IMPLICATIONS: This study evaluated oxygen saturation monitors in a canine model of acute blood loss and resuscitation with a blood substitute and found that these may interfere with the monitors’ results in a dose-dependent way.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999