Postoperative management: The role of mixed venous oxygen saturation monitoring

The results of the Norwood operation have improved considerably over the last decade, due in part to improvement in postoperative care. Mixed venous oxygen saturation (Mvo2) monitoring has been an important addition to postoperative management. Our use of Mvo2 monitoring in Norwood patients has included 96 infants operated from 1996 to the present. This strategy has proven to be technically straightforward and adds information not provided by monitoring systemic saturation alone. Mvo2 has a nadir at 6-12 hours after surgery and below a value of 30% is associated with anaerobic metabolism. It identifies patients at risk for early mortality. It also allows evaluation of management of treatment strategies that evolve over time and of specific interventions in individual patients. Optimizing Mvo2 constitutes an important goal of postoperative management after the Norwood procedure.