Use of femoral vein catheters for the assessment of perfusion parameters

The use of central venous oxygen saturation (SvcO(2)) and arterial lactate in the diagnosis of severe tissue hypoperfusion is well established, and the optimization of these parameters is currently under investigation, particularly in patients with severe sepsis/septic shock. However, the only place for deep venous puncture or the first choice for puncture is often the femoral vein. Although venous saturation obtained from blood sampling from this catheter, instead of SvcO(2), has already been used in the diagnosis of severe tissue hypoperfusion, little is known about the accuracy of the results. The venous lactate in place of arterial puncture has also been used to guide therapeutic decisions. We conducted this literature review to seek evidence on the correlation and concordance of parameters obtained by collecting femoral venous blood gases in relation to SvcO(2) and arterial lactate. Few studies in the literature have evaluated the use of femoral venous oxygen saturation (SvfO(2)) or venous lactate. The results obtained thus far demonstrate no adequate agreement between SvfO(2) and SvcO(2), which limits the clinical use of SvfO(2). However, the apparent strong correlation between arterial and peripheral and central venous lactate values suggests that venous lactate obtained from the femoral vein could eventually be used instead of arterial lactate, although there is insufficient evidence on which to base this procedure at this time.