Document Detail


Central venous oxygen saturation for the diagnosis of low cardiac output in septic shock patients.
MedLine Citation:
PMID:  19735495     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Simple diagnostic tests are needed to screen septic patients for low cardiac output because intervention is recommended in these patients. We assessed the diagnostic value of central venous oxygen saturation in the superior vena cava (ScvO(2)) for detecting low cardiac output in patients with septic shock. METHODS: We conducted a prospective observational study in three general intensive care units (ICUs) of adult patients with septic shock, who were to have a catheter inserted for thermodilution measurement of cardiac index (CI(TD)). Paired measurements of CI(TD) and central venous oximetry values were obtained when the clinician first measured CI(TD). RESULTS: We included 56 patients with septic shock and a mean sequential organ failure assessment score of 12 (range 3-20). Baseline CI(TD) was 3.5 l/min/m(2) (1.0-6.2) and ScvO(2) of 70% (33-87). The best cut-off of ScvO(2) for CI(TD)>2.5 l/min/m(2) (n=42) was a value >or=64% with positive and negative predictive values of 91% (95% confidence interval 79-98) and 91% (59-100), respectively. The diagnostic values were not improved by using instead central venous O(2) tension or the difference between arterial and central venous O(2) saturation. CONCLUSIONS: This prospective, observational study found that a ScvO(2) measurement of >or=64% indicated CI(TD)>2.5 l/min/m(2) in ICU patients with septic shock.
Authors:
A Perner; N Haase; J Wiis; J O White; A Delaney
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Publication Detail:
Type:  Journal Article     Date:  2009-09-07
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-07     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  98-102     Citation Subset:  IM    
Affiliation:
Department of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. anders.perner@rh.regionh.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiac Output, Low / diagnosis*
Catheterization, Central Venous
Humans
Oximetry / methods*
Oxygen / blood*
Predictive Value of Tests
Prospective Studies
Shock, Septic / physiopathology*
Vena Cava, Superior
Young Adult
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

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