[Mixed venous oxygen saturation as optimization of the therapeutic response in low output syndrome]. / SvO2 come ottimizzazione della risposta terapeutica nella sindrome da bassa gittata.

The Authors report on their experience about SvO2 continuous monitoring in order to find out the best therapeutic answer to inotropic drugs, knowing that, at constant values of SaO2 and Hb, possible variations of SvO2 reliably correspond with parallel variations of cardiac index (IC). Two groups of 15 patients each, suffering from low out-put syndrome, have been studied; patients have been treated with inotropic therapy based on Dobutamina and Amrinone. The 2 groups only differed from each other for the kind of monitoring: the first group was exposed to intermittent measurements of the cardiac out-put, while the second group was exposed to continuous monitoring of SvO2. Analysing the obtained results, the Authors notice not only a close correlation between the improvement of SvO2 and IC, but also a significant rediction in time required to dose drugs, owing to the constant help provided by on-line monitoring of SvO2. (table; see text)

[Multiple organ system failure: analysis of oximetry parameters among survivors and non-survivors]. / Multiple organ system failure: analisi comportamentale dei parametri ossimetrici tra survivors e not survivors.

The authors have studied the relationship between SvO2 and many parameters of oxygenation in MOSF patients specially in surviving patients and not surviving ones. They found that there is a close correlation between SvO2 and CI in the survivors indicates that, in these patients, we can increase cardiac activity to improve the cellular demand.

[Role of oxygen venous saturation monitoring and CAVH in the multiple organ failure syndrome. Description of a clinical case]. / Ruolo della SvO2 e della CAVH nella sindrome da scompenso multiorgano (MOFS). Descrizione di un caso clinico.

A 42 year old man was admitted to the intensive Care Unit with signs and symptoms of septic shock, associated with adult respiratory distress syndrome (ARDS), jaundice and acute renal failure. In order to support different organs failures mechanical ventilation (IPPV, PSV, CPAP), continuous arteriovenous hemofiltration were affected, and continuous intravenous infusion of dopamine and dobutamine was started. After and during application of these therapeutic measures, continuous monitoring of mixed venous blood oxygen saturation (SvO2) was applied by Swan-Ganz fiber optic catheter in the pulmonary artery. Monitoring of SvO2 represented a useful means to guide inotropic therapy and to assess the hemodynamic effects of CAVH and mechanical ventilation. The case reported emphasized the role of continuous venous oximetry in multiple organ failure syndrome.

[Efficacy and safety of amrinone in the treatment of heart insufficiency in intensive care]. / Efficacia e tollerabilità dell'amrinone nel trattamento dell'insufficienza cardiaca in terapia intensiva.

The authors describe the results obtained treating with amrinone for 48 hours 11 patients with acute heart failure. The patients (4 males and 7 females), age range between 50 and 82 years) received an initial bolus of 0.75 mg/kg followed by and infusion which on average was of 5.82 +/- 1.06 (SD) micrograms/kg/min. Besides a subjective and objective clinical improvement they could observe a quick and remarkable improvement of the main hemodynamic parameters (cardiac index, cardiac output, pulmonary capillary wedge pressure, mean pulmonary pressure). The tolerability of the drug was good, except for a decrease in platelet, already described in literature. In conclusion, the Authors consider amrinone a very interesting drug for its positive inotropic and vasodilating activity and because it does not cause an increase of the myocardial oxygen consumption.