Mixed Venous Oxygen Saturation Monitoring
This procedure uses a fiber-optic thermodilution pulmonary artery (PA) catheter to continuously monitor oxygen delivery to tissues and oxygen consumption by tissues. Monitoring of mixed venous oxygen saturation (S[v with bar above]−O2) allows rapid detection of impaired oxygen delivery, such as from decreased cardiac output, hemoglobin level, or arterial oxygen saturation. It also helps evaluate a patient’s response to drug therapy, endotracheal tube suctioning, ventilator setting changes, positive end-expiratory pressure, and fraction of inspired oxygen. S[v with bar above]−O2 usually ranges from 60% to 80%.
Equipment
Fiber-optic PA catheter ▪ co-oximeter and monitor ▪ optical module and cable ▪ gloves.
Preparation of Equipment
Review the manufacturer’s instructions for assembly and use of the fiber-optic PA catheter. Connect the optical module and cable to the monitor. Next, peel back the wrapping covering the catheter just enough to uncover the fiber-optic connector. Attach the fiber-optic connector to the optical module while allowing the rest of the catheter to remain in its sterile wrapping. Calibrate the fiber-optic catheter by following the manufacturer’s instructions.
To prepare for the rest of the procedure, follow the instructions for pulmonary catheter insertion, as described in “Pulmonary artery pressure and pulmonary artery wedge pressure monitoring,” page 610. (See S[v with bar above]−O2 monitoring equipment.)
Implementation
Verify the doctor’s order.
Confirm the patient’s identity using with at least two patient identifiers according to your facility’s policy.1
Explain the procedure to the patient and answer any questions to allay his fears and promote cooperation.
Assist with the insertion of the fiber-optic catheter just as you would for a PA catheter.
After the catheter is inserted, confirm that the light intensity tracing on the graphic printout is within normal range to ensure correct positioning and function of the catheter.
Observe the digital readout and record the S[v with bar above]−O2 on graph paper. Repeat readings at least once each hour to monitor and document trends.
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