ABSTRACT
OBJECTIVE: To evaluate the changes over time (trend) in sign and magnitude for SSVO2 and SVO2 during and after cardiac surgery. PATIENTS AND METHODS: A prospective and observational study was conducted on 34 cardiac surgery patients. Venous blood samples were taken simultaneously from the introductor (SVCO2) and distal (SVO2) port of the pulmonary artery catheter at predefined intervals. Systemic and pulmonary hemodynamic variables were measured at the same time. The trend was calculated as the difference between 2 consecutive measurements (tSO2). Data were processed with ANOVA for multiple comparisons, Pearson correlation coefficient and Bland-Altman analysis. RESULTS: There was a significant correlation between SVCO2 and tSVO2 (R(2)=0.55), the mean of the differences was 0.36±7.75%, and the limits of agreement ranged from -15.1 to 15.9%. The sign of the trend was similar in 85.1% of the paired data. However, the magnitude of the changes in tSVCO2 and tSVO2 were not always equivalent. Between 0 and 5% of the change in the tSVCO2 was coincident with only 44.7% of the tSVO2. A wide variation was found between both trends when the signs and magnitudes of the changes were taken into account. CONCLUSIONS: When considering the sign and magnitude, the change over time of central venous O2 saturations were not interchangeable in cardiac surgery patients. Clinical decisions based exclusively on tSVCO2 monitoring should be taken with caution.
Subject(s)
Cardiac Surgical Procedures , Oxygen/metabolism , Pulmonary Artery , Vena Cava, Superior , Female , Humans , Intraoperative Period , Male , Middle Aged , Monitoring, Intraoperative , Prospective StudiesABSTRACT
Se determinaron los niveles de DDE-MeSO2, DDT y DDE en 51 muestras de leche materna y en 40 muestras de sangre venosa de mujeres que viven en zonas donde el DDT se aplicó para el control de la malaria. Las concentraciones de los tres compuestos en leche materna en las diferentes comunidades fueron: El Ramonal 2.8 ng/glípido, 911 ng/glípido, 3100 ng/glípido; La Cigüeña 1.2 ng/glípido,134 ng/glípido, 764 ng/glípido; Tapachula 0.5 ng/glípido, 17 ng/glípido, 683 ng/glípido; la Huasteca 1.4 ng/glípido, 46 ng/glípido,490 ng/glípido; y Faja de Oro 0.4 ng/glípido, 18 ng/glípido, 268 ng/glípido. Las concentraciones encontradas de DDE-MeSO2 enEl Ramonal son siete veces mayores a las reportadas en Suecia en 1992 (0.4 ng/glípido). Los niveles de exposición a los 3 compuestos en sangre venosa fueron: Lacanjá 64 ng/glípido, 1323 ng/glípido, 3738 ng/glípido; El Ramonal 20 ng/glípido, 748 ng/glípido, 1271 ng/glípido; La Cigüeña 66 ng/glípido, 424 ng/glípido, 1059 ng/glípido; y Ventanilla 43 ng/glípido, 335 ng/glípido,1362 ng/glípido; de DDE-MeSO2, DDT y DDE respectivamente. Las comunidades de Lacanjá y La Cigüeña presentaron los mayores niveles de exposición al DDE-MeSO2, que comparados con los reportes de Eslovaquia son nueve veces mayor (7.3 ng/glípido).
The levels of the DDE-MeSO2, DDT andDDE were determined in 51 breast milk samples and in 40 blood samples from women living in endemic areas of malaria. The concentrations of the three compounds in maternal milk were: El Ramonal 2.8 ng/glipid, 911 ng/glipid, 3100 ng/glipid; La Cigueña 1.2 ng/glipid, 134 ng/glipid, 764 ng/glipid; Tapachula 0.5 ng/glipid, 17 ng/glipid, 683 ng/glipid; Huasteca 1.4 ng/glipid,46 ng/glipid, 490 ng/glipid; and Faja de Oro 0.4 ng/glipid, 18 ng/glipid, 268 ng/glipid. The concentrations of DDE-MeSO2 found in El Ramonal were seven times higher than those reported in Sweden in 1992 (0.4 ng/glipid). In blood the levels of the threecompounds were: Lacanjá 64 ng/glipid, 1323 ng/glipid, 3738 ng/glipid; El Ramonal 20 ng/glipid, 748 ng/glipid, 1271 ng/glipid; La Cigueña 66 ng/glipid, 424 ng/glipid, 1059 ng/glipid; and Ventanilla 43 ng/glipid, 335 ng/glipid, 1362 ng/glipid. The concentrations of DDE-MeSO2 in Lacanjá and La Cigueña were nine times than those reported in Slovakia (7.3 ng/glipid).
Subject(s)
Humans , Female , DDT , Dichlorodiphenyl Dichloroethylene/analysis , Dichlorodiphenyl Dichloroethylene/toxicity , Insecticides/adverse effects , Insecticides/toxicity , Environmental Pollutants/adverse effects , Environmental Exposure/adverse effects , Milk, Human/chemistry , Malaria/prevention & control , Mexico/epidemiologyABSTRACT
Objective. To assess the comparability of hemoglobin concentration (Hb) in venous and capillary blood measured by Hemocue and an automated spectrophotometer (Celldyn) and to document the influence of type of blood (capillary or venous) and analysis method on anemia prevalence estimates. Material and Methods. Between February and May 2000, capillary and venous samples were collected from 72 adults and children at Hospital del Niño Morelense (Morelos State Children's Hospital) in Cuernavaca, Morelos, Mexico, and assessed for Hb using the Hemocue and Celldyn methods. Estimated Hb levels were compared using the concordance correlation coefficient and Student's t test for paired data. The sensitivity and specificity for anemia diagnosis were estimated and compared between type of blood and method of assessment. Results. Capillary blood had higher Hb (+0.5g/dl) than venous blood in adults and children, as did samples assessed by Celldyn compared to Hemocue (+0.3g/dl). Specificity to detect anemia was adequate (>0.90) but sensitivity was low for capillary blood assessed by Hemocue (<0.80). Conclusions. The difference in Hb between venous and capillary blood is likely related to biological variability. Hemoglobin concentration in capillary blood assessed by Hemocue provides an adequate estimation of population anemia prevalence but may result in excess false negative diagnoses among individuals. The results of this study stress the importance of sample collection technique, particularly for children. Method of analysis and sampling site need to be taken into consideration in field studies.
Objetivo. Evaluar la comparabilidad de la concentración de hemoglobina (Hb) en sangre venosa y capilar medida por Hemocue y por espectrofotómetro automatizado (Celldyn), así como documentar la influencia del tipo de sangre (capilar o venosa) y del método de análisis sobre la prevalencia de anemia. Material y métodos. De febrero a mayo de 2000, se recolectaron muestras de sangre capilar y venosa en 72 adultos y niños en el Hospital del Niño Morelense, Cuernavaca, Morelos, México. Se determinaron los niveles de Hb con los métodos Hemocue y Celldyn. Las cifras de Hb estimadas se compararon con el coeficiente de concordancia y la prueba pareada de t de Student. También se comparó la sensibilidad y especificidad para el diagnóstico de anemia, utilizando sangre de los dos tipos y métodos de análisis. Resultados. La Hb fue mayor en sangre capilar comparada con sangre venosa (+0.5g/dl) en adultos y niños, y en las determinaciones por Celldyn comparadas con las de Hemocue (+0.3 g/dl). La especificidad para el diagnóstico de anemia fue adecuada (>0.90), mientras que la sensibilidad fue baja para las muestras capilares medidas por Hemocue (<0.80). Conclusiones. Es probable que la diferencia en la Hb entre sangre venosa y capilar refleje variabilidad biológica. La Hb en sangre capilar medida por Hemocue provee una estimación adecuada de la prevalencia de anemia en poblaciones, pero podría resultar en un exceso de diagnósticos falsos negativos. Los resultados de este estudio ponen énfasis en la importancia de la técnica de recolección de la muestra, particularmente en niños. Los métodos de análisis y tipos de muestra de sangre deben ser tomados en cuenta en estudios de campo.
