Background: Mixed venous oxygen monitoring (SvO2) has a well-defined role for guiding hemodynamic management in adults and children undergoing major surgical operations. Central venous oxygen saturation measurement (ScvO2) can be a surrogate for mixed venous oxygen saturation measurement (SvO2). This study aims to determine the accuracy of central venous oxygenation (ScvO2) in predicting outcomes in acyanotic pediatric patients undergoing cardiac surgery.
Method: In a prospective cohort study, 61 acyanotic pediatric patients age 1month to 18 years old, undergoing cardiac surgery with cardiopulmonary bypass were selected. A pre-bypass central venous oxygen saturation measurement was obtained through the CVP line. At the surgical ICU, patients were observed for the following outcomes: mechanical ventilation time, re-intubation, use of more than 2 inotropes, use of PRBC at > 15ml /kg, ICU stay, neurologic complications, acute renal failure, pulmonary complications, occurrence of sepsis, and hospital mortality.
Results: There were no statistical differences positive and negative outcome when patients are grouped according to sex (P=0.86), lesion (P=0.31), size of lesion (P=0.31), PA pressure (P=0.09), ScvO2 (P=0.87), bypass time (P=0.20), and ischemic time (P=0.38). Age (P=0.020) and weight (P=0.020) are significant with p-value below 0.05. The identified cut off value for determining outcomes in pediatric cardiac surgeries is below or equal to 70.7% (41.18% sensitivity, 81.82% specificity).
Conclusion: Measurements of central venous oxygen saturation provide an index of tissue oxygenation. Although ScvO2 more than 70.7% do not rule out tissue hypoxia, values 70.7% and below may represent a reliable warning sign for a positive outcome.