Venous oxygen saturation in critical illness.

OBJECTIVE: To review clinically relevant features of systemic oxygen delivery and consumption and the technique and use of venous oxygenation monitoring in human and veterinary medicine. DATA SOURCES: Veterinary and human peer-reviewed medical literature including scientific reviews, clinical and laboratory research articles, and authors' clinical research experience.
SUMMARY: Measurement of venous hemoglobin oxygen saturation (venous oxygenation) provides insight into the balance between oxygen supply and tissue demand. In people, measurement of venous oxygen saturation can reveal decompensation that is missed by physical examination and other routinely monitored parameters. Therefore, measurement of mixed or central venous oxygenation measurement may help guide therapy and predict outcome of critically ill patients. In dogs, low central venous oxygen saturation has been associated with impaired cardiopulmonary function and poor outcome in several small studies of experimental shock or severe clinical illness, suggesting that monitoring this variable may assist the treatment of severe illness in this species as well.
CONCLUSION: Venous oxygenation reflects systemic oxygenation status and can be used to guide treatment and estimate prognosis in critically ill patients. Measurement of venous oxygenation in veterinary patients is feasible and is a potentially valuable tool in the management of patients with severe disease. This review is intended to increase the understanding and awareness of the potential role of venous oxygen measurement in veterinary patients. © Veterinary Emergency and Critical Care Society 2018.