CONTINUOUS MONITORING OF INTERNAL JUGULAR OXYGEN SATURATION: CLINICAL APPLICATION OF FIBEROPTIC CATHETER OXIMETER Yong-Gi Kim 1 , Kunio Wada 1 , Takao Minami 1 , Kikushi Katurada 1 1Department of Emergency Medicine, Osaka Prefectural Hospital pp.951-958
Published Date 1976/9/1
DOI https://doi.org/10.11477/mf.1406203946
  • Abstract
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Fiberoptic catheter oximeter instruments had been developed and already used clinically for continuous measurement of central venous SO2 (oxygen saturation). In this paper, an attempt was made for monitoring of SO2 of internal jugular venous blood (SjvO2).

As to the instrument-IN VIVO OXIMETER (Physio-Control, Seattle, USA), the capability and reliability of measuring SO2 were discussed else-where following some in vitro experiments. Thepresent study was designed to clarify the possibility and the significance of its clinical application for Sjv02 measurement.

The tip of fiberoptic catheter was placed at superior jugular bulb on the patients suffering from recent intracranial hemorrhage. Calibration was made several times a day by in vito measurement of SO2 using CO-Oximeter. The monitoring of SjvO2 was continued for over than 24 hours.

The instrument worked satisfactorily in a limited number of patients. And as a results, the reliable SO2 curve was obtained besides some technical troubles, which concerned with the insertion technic of a catheter and catheter tip artifacts. One of the common artifacts was caused by clot formation at the catheter tip and the other by impinging of tip on the vessel wall. The last might be a flow arti-fact which resulted in small fluctuation of unknown origin in SO2 curve. Despite these limitations, the clinical experiences warranted the use of a fiber-optic in vivo oximeter for continuous monitoring of cerebral metabolism in selective comatose patients.

It should be stressed that the new technic could detect the rapid changes of cerebral metabolism following anoxic episodes or acute cardiac failure. And it was proved in this study that the continuous measurement of SjvO2 provided the more rapid and reliable prognostic signs than intracranial pres-sure or other clinical parameters. The phenomenon of internal jugular hyperoxia in critically ill patients, which was reconfirmed in the present study, had been reported and discussed in the previous paper.

Copyright © 1976, Igaku-Shoin Ltd. All rights reserved.


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