Capnodynamic assessment of mixed venous oxygen saturation in a porcine experimental endotoxemic model
Abstract Sepsis continues to be a major cause of death and illness globally, posing significant challenges for healthcare professionals. In the pursuit of more accurate and timely monitoring tools, the concept of capnodynamically derived mixed venous oxygen saturation (Capno-SvO2) has emerged as a p...
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Nature Portfolio
2024-11-01
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| author | Anders Svedmyr Joakim Hedov Miklos Lipcsey Mats Wallin Magnus Hallbäck Per-Arne Lönnqvist Jacob Karlsson |
| author_facet | Anders Svedmyr Joakim Hedov Miklos Lipcsey Mats Wallin Magnus Hallbäck Per-Arne Lönnqvist Jacob Karlsson |
| author_sort | Anders Svedmyr |
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| description | Abstract Sepsis continues to be a major cause of death and illness globally, posing significant challenges for healthcare professionals. In the pursuit of more accurate and timely monitoring tools, the concept of capnodynamically derived mixed venous oxygen saturation (Capno-SvO2) has emerged as a promising method. Capno-SvO2 provides a non-invasive way to assess and track SvO2 and could serve as an additional tool alongside more invasive methods like the pulmonary artery catheter. This could potentially be of great value in the care of critically ill patients with sepsis, where alternative minimal invasive monitoring methods may vary in reliability. The aim of the current study was to compare capno-SvO2 against values obtained through pulmonary artery blood sample CO-oximetry and continuous fiberoptic SvO2 monitoring, using a well-established porcine experimental sepsis model. Anesthetized pigs were exposed to a standardized endotoxin infusion sepsis protocol, followed by a series of maneuvers typically applied in sepsis care. Simultaneous recordings were done throughout the experiment for all three monitoring methods. Bland–Altman analysis corrected for repeated measurements was used to assess the agreement of absolute values between the paired recording of CO-oximetry and Capno-SvO2 as well as between CO-oximetry and fiberoptic SvO2. The ability of Capno-SvO2 and fiberoptic SvO2 to track changes was assessed by concordance rate. A total of 10 animals and 275 paired datapoints were included in the study. The majority of the animals displayed pronounced hemodynamical instability in response to endotoxin exposure and subsequent treatment interventions. Analysis of all paired data points showed a bias between Capno-SvO2 and CO-oximetry SvO2 of + 1% with 95% limits of agreement of -14% to + 17%. The corresponding numbers for fiberoptic SvO2 and CO-oximetry SvO2 were -4% and -15% to + 8%. The concordance rate as compared to CO-oximetry, were 97% and 93% for Capno-SvO2 and fiberoptic SvO2, respectively. In this experimental sepsis model, continuous, non-invasive Capno-SvO2 generates average absolute values comparable to the gold standard CO-oximetry albeit with relatively wide limits of agreement. Capno-SvO2 displayed a concordance rate of 97% against CO-oximetry and exhibits better trending ability compared to invasive fiberoptic SvO2. |
| format | Article |
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| spelling | doaj-art-dea70ca3f2df4a3981cbacc204aede2d2025-08-20T02:13:24ZengNature PortfolioScientific Reports2045-23222024-11-0114111110.1038/s41598-024-77483-7Capnodynamic assessment of mixed venous oxygen saturation in a porcine experimental endotoxemic modelAnders Svedmyr0Joakim Hedov1Miklos Lipcsey2Mats Wallin3Magnus Hallbäck4Per-Arne Lönnqvist5Jacob Karlsson6Department of Physiology and Pharmacology, (FYFA), Karolinska Institute, C3, PA Lönnqvist Group- Section of Anesthesiology and Intensive CarePediatric Perioperative Medicine and Intensive Care, Karolinska University HospitalDepartment of Surgical Sciences, Section of Anesthesiology and Intensive Care, Uppsala UniversityDepartment of Physiology and Pharmacology, (FYFA), Karolinska Institute, C3, PA Lönnqvist Group- Section of Anesthesiology and Intensive CareMaquet Critical Care ABDepartment of Physiology and Pharmacology, (FYFA), Karolinska Institute, C3, PA Lönnqvist Group- Section of Anesthesiology and Intensive CareDepartment of Physiology and Pharmacology, (FYFA), Karolinska Institute, C3, PA Lönnqvist Group- Section of Anesthesiology and Intensive CareAbstract Sepsis continues to be a major cause of death and illness globally, posing significant challenges for healthcare professionals. In the pursuit of more accurate and timely monitoring tools, the concept of capnodynamically derived mixed venous oxygen saturation (Capno-SvO2) has emerged as a promising method. Capno-SvO2 provides a non-invasive way to assess and track SvO2 and could serve as an additional tool alongside more invasive methods like the pulmonary artery catheter. This could potentially be of great value in the care of critically ill patients with sepsis, where alternative minimal invasive monitoring methods may vary in reliability. The aim of the current study was to compare capno-SvO2 against values obtained through pulmonary artery blood sample CO-oximetry and continuous fiberoptic SvO2 monitoring, using a well-established porcine experimental sepsis model. Anesthetized pigs were exposed to a standardized endotoxin infusion sepsis protocol, followed by a series of maneuvers typically applied in sepsis care. Simultaneous recordings were done throughout the experiment for all three monitoring methods. Bland–Altman analysis corrected for repeated measurements was used to assess the agreement of absolute values between the paired recording of CO-oximetry and Capno-SvO2 as well as between CO-oximetry and fiberoptic SvO2. The ability of Capno-SvO2 and fiberoptic SvO2 to track changes was assessed by concordance rate. A total of 10 animals and 275 paired datapoints were included in the study. The majority of the animals displayed pronounced hemodynamical instability in response to endotoxin exposure and subsequent treatment interventions. Analysis of all paired data points showed a bias between Capno-SvO2 and CO-oximetry SvO2 of + 1% with 95% limits of agreement of -14% to + 17%. The corresponding numbers for fiberoptic SvO2 and CO-oximetry SvO2 were -4% and -15% to + 8%. The concordance rate as compared to CO-oximetry, were 97% and 93% for Capno-SvO2 and fiberoptic SvO2, respectively. In this experimental sepsis model, continuous, non-invasive Capno-SvO2 generates average absolute values comparable to the gold standard CO-oximetry albeit with relatively wide limits of agreement. Capno-SvO2 displayed a concordance rate of 97% against CO-oximetry and exhibits better trending ability compared to invasive fiberoptic SvO2.https://doi.org/10.1038/s41598-024-77483-7SvO2Mixed venous saturationSepsisSeptic shockHemodynamic monitoringNon-invasive |
| spellingShingle | Anders Svedmyr Joakim Hedov Miklos Lipcsey Mats Wallin Magnus Hallbäck Per-Arne Lönnqvist Jacob Karlsson Capnodynamic assessment of mixed venous oxygen saturation in a porcine experimental endotoxemic model Scientific Reports SvO2 Mixed venous saturation Sepsis Septic shock Hemodynamic monitoring Non-invasive |
| title | Capnodynamic assessment of mixed venous oxygen saturation in a porcine experimental endotoxemic model |
| title_full | Capnodynamic assessment of mixed venous oxygen saturation in a porcine experimental endotoxemic model |
| title_fullStr | Capnodynamic assessment of mixed venous oxygen saturation in a porcine experimental endotoxemic model |
| title_full_unstemmed | Capnodynamic assessment of mixed venous oxygen saturation in a porcine experimental endotoxemic model |
| title_short | Capnodynamic assessment of mixed venous oxygen saturation in a porcine experimental endotoxemic model |
| title_sort | capnodynamic assessment of mixed venous oxygen saturation in a porcine experimental endotoxemic model |
| topic | SvO2 Mixed venous saturation Sepsis Septic shock Hemodynamic monitoring Non-invasive |
| url | https://doi.org/10.1038/s41598-024-77483-7 |
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