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Journal of Clinical Monitoring and Computing

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Open Access 14-02-2023 | Original Research

Oxygen saturation in intraosseous sternal blood measured by CO-oximetry and evaluated non-invasively during hypovolaemia and hypoxia – a porcine experimental study

Authors: Erik Näslund, Lars-Göran Lindberg, Gunnar Strandberg, Catharina Apelthun, Stephanie Franzén, Robert Frithiof

Published in: Journal of Clinical Monitoring and Computing | Issue 3/2023

Abstract

Purpose: This study intended to determine, and non-invasively evaluate, sternal intraosseous oxygen saturation (SsO₂) and study its variation during provoked hypoxia or hypovolaemia. Furthermore, the relation between SsO₂ and arterial (SaO₂) or mixed venous oxygen saturation (SvO₂) was investigated. Methods: Sixteen anaesthetised male pigs underwent exsanguination to a mean arterial pressure of 50 mmHg. After resuscitation and stabilisation, hypoxia was induced with hypoxic gas mixtures (air/N₂). Repeated blood samples from sternal intraosseous cannulation were compared to arterial and pulmonary artery blood samples. Reflection spectrophotometry measurements by a non-invasive sternal probe were performed continuously. Results: At baseline SaO₂ was 97.0% (IQR 0.2), SsO₂ 73.2% (IQR 19.6) and SvO₂ 52.3% (IQR 12.4). During hypovolaemia, SsO₂ and SvO₂ decreased to 58.9% (IQR 16.9) and 38.1% (IQR 12.5), respectively, p < 0.05 for both, whereas SaO₂ remained unaltered (p = 0.44). During hypoxia all saturations decreased; SaO₂ 71.5% (IQR 5.2), SsO₂ 39.0% (IQR 6.9) and SvO₂ 22.6% (IQR 11.4) (p < 0.01), respectively. For hypovolaemia, the sternal probe red/infrared absorption ratio (SQV) increased significantly from baseline (indicating a reduction in oxygen saturation) + 5.1% (IQR 7.4), p < 0.001 and for hypoxia + 19.9% (IQR 14.8), p = 0.001, respectively. Conclusion: Sternal blood has an oxygen saturation suggesting a mixture of venous and arterial blood. Changes in SsO₂ relate well with changes in SvO₂ during hypovolaemia or hypoxia. Further studies on the feasibility of using non-invasive measurement of changes in SsO₂ to estimate changes in SvO₂ are warranted.

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Title: Oxygen saturation in intraosseous sternal blood measured by CO-oximetry and evaluated non-invasively during hypovolaemia and hypoxia – a porcine experimental study
Authors: Erik Näslund
Lars-Göran Lindberg
Gunnar Strandberg
Catharina Apelthun
Stephanie Franzén
Robert Frithiof
Publication date: 14-02-2023
Publisher: Springer Netherlands
Published in: Journal of Clinical Monitoring and Computing / Issue 3/2023
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-023-00980-z

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Oxygen saturation in intraosseous sternal blood measured by CO-oximetry and evaluated non-invasively during hypovolaemia and hypoxia – a porcine experimental study

Abstract

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