ScVO2 Catheter Protocol

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Policy and Procedure:

Indications for Fibrotic Catheter Insertion and ScvO2 Monitoring in ICU:

Patients who require pulmonary artery catheterization for optimization of hemodynamic or oxygen kinetic balance shall be considered for a fibrotic pulmonary artery catheter (ScvO2). No fibrotic PA catheter (ScvO2) will be placed unless the patient meets appropriate indications as defined by this policy. The physician staff may decide to treat any patient even if they do not meet the criteria defined by this policy. Continuous ScvO2 monitoring may be indicated under the following conditions for patients treated by the Trauma, Burn Surgery Service.

  1. On admission, any TBE patient who meets any of the following conditions:
    • Systemic acidosis (pH < 7.30, and/or persistent hypotension with SBP < 100, and/or UO < 30-50 mL/hr) not corrected by what appears to be appropriate fluid resuscitation (ATLS guidelines).
    • An associated head injury undergoing aggressive ICP therapy (mannitol, diuretics, phenobarbital)
    • Associated major trauma with a history of heart (i.e., ischemic, valvular) liver (i.e. cirrhosis), pulmonary disease (i.e., COPD), or chronic renal failure requiring renal replacement therapy.
    • Thermally injured patients who have a major inhalation injury documented by bronchoscopy regardless of the total surface area of the injury.
    • Pulmonary failure defined by any of the following conditions:
      • PaO2 / FIO2 ratio < 200.
      • SaO2 < 0.90 with FIO2 > 0.50 and PEEP > 10 cmH2
      • Static compliance < 30 mL / cmH2
      • Intrapulmonary shunt > 25%.
    • Massive fluid resuscitation ( > 10 Liters crystalloid or 10 units blood products) with any of the preceding conditions.
  2. Following admission all ACS Service patients will be monitored daily for the development of conditions which would warrant pulmonary artery catheterization. The conditions which would indicate a possible need for invasive PA-ScvO2 monitoring are:
    • Pulmonary failure as defined by any of the following:
      • PaO2 / FIO2 ratio < 250.
      • SaO2 < 0.90 with FIO2 > 0.50 and PEEP > 10 cmH2
      • Static compliance < 30 ml / cmH2
      • Intrapulmonary shunt > 25%
    • Cardiovascular failure as defined by:
      • Evidence of ischemic dysfunction.
      • Systemic acidosis (as previously defined).
    • Renal failure defined by:
      • UO < 30-50 cc/hr (for adults) following fluid challenge.
      • Creatinine > 2x baseline admission value.

ScvO2 catheters will be changed for any of the following reasons:

  1. If no evidence of infection.
  2. Non-functional ScvO2.

Goals of Monitoring:

  1. Optimize cardiac and pulmonary function as evidenced by:
    • SaO2 > 0.90.
    • Cardiac index > 2.5 L/min/M2.
    • Urine output > 30-50 cc/hr for adults.
    • SvO2 > 0.65.
    • VO2 (I) < 170 ml/min/M2.
    • PaO2 / FIO2 ratio > 250.
  2. Decrease unwarranted ancillary hemodynamic testing (thermal dilution cardiac output).

Special Thanks


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  1. Title: ScVO2 Catheter Protocol
  2. Author:  Michigan Medicine
  3. Source: The URL where the image is hosted.
  4. License: “CC BY-NC 4.0”

ScVO2 Catheter Protocol,  Michigan Medicine, Dept of Surgery,  “CC BY-NC 4.0”

Last reviewed: 09 June 2021