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SvO2 monitoring
25
Transcript
SVO2 (mixed venous oxygen saturation)
- measured in the pulmonary artery (PA)
- venous blood mixes after circulating through:
- superior and inferior vena cavae
- coronary sinuses
- chambers in the right side of the heart
- Although SVO2 is the % of O2 saturation in the pulmonary arterial blood, it actually represents an average of all the venous oxygen saturations of the various organs and tissues
- blood products
- diuresis
- airway pressure tracing
- flow wave form (expiratory portion)
- flow volume loop - same
- pressure volume loop
- Check for kinks in ETT & breathing circuit tubing
- Extrinsic compression of upper airway
- Ascultate.
- Are breath sounds clear?
- Secretions?
- Bronchospasm?
- Do you have breath sounds in all lobes?
- Mucous plug?
SVO2 Monitoring:
Why is my patient's SVO2 low?
Lorraine Keller, UNF SRNA
SvO2
O2D
VO2
oxygen delivery
oxygen consumption
- bleeding
- hemodilution
Hgb
CaO2
CO
arterial oxygen content
cardiac output
CaO2 = (Hb x SaO2 x 1.36) + (PaO2 x 0.03)
airway resistance
SaO2
- IV fluids
- colloids
- blood products
diuretics
HR
SV
(pulm edema)
- pressure volume loop
- more difficult to manually bag
compliance
CVP, PCWP
good perfusing rhythm?
Appropriate ventilator settings?
1. preload ( )
2. afterload ( )
3. contractility ( )
- vasopressors
- vasodilators
- Restrictive interstitial lung dz
- Pneumonia, ALI, ARDS
- Check I&O balance: pulmonary edema?
SVR, PVR
check rhythm
vagal response?
iatrogenic effects
communicate with surgeon
medications
electrolytes?
inotropic support
cardiogenic vs. noncardiogenic
transpulmonary gradient
assess SV
combined therapy
diuretics
vasodilators
inotropes
alveolar recruitment
PEEP, NO
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