Document Detail


ScvO(2) as a marker to define fluid responsiveness.
MedLine Citation:
PMID:  20805770     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Definition of the hemodynamic response to volume expansion (VE) could be useful in shocked critically ill patients in absence of cardiac index (CI) measurements. The aim of this study is to evaluate whether central venous oxygen saturation variations (ΔScvO(2)) after VE could be an alternative to classify responders (R) and nonresponders (NR) to volume therapy.
METHODS: A total of 30 patients requiring VE were included in this prospective cohort study, all equipped with radial arterial line and pulmonary artery catheters. CI, mixed venous oxygen saturation (SvO(2)) and ScvO(2) were measured before and after VE. CI, SvO(2), and ScvO(2) changes after volume were analyzed using linear regression. Receiver operating characteristics curve analysis was used to test their ability to distinguish R and NR.
RESULTS: ΔScvO(2) and SvO(2) variations after VE (ΔSvO(2)) were significantly correlated with CI changes (ΔCI) after VE (r = 0.67 and r = 0.49, p < 0.001, respectively). A ΔScvO(2) threshold value of 4% allowed the definition of R and NR patients with 86% sensitivity (95%CI; 57-98%) and 81% specificity (95%CI; 54-96%).
CONCLUSIONS: ScvO2 variations after VE was able to categorize VE efficiently and could be suggested as an alternative marker to define fluid responsiveness in absence of invasive CI measurement.
Authors:
Raphael Giraud; Nils Siegenthaler; Angèle Gayet-Ageron; Christophe Combescure; Jacques-André Romand; Karim Bendjelid
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  70     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-05-25     Completed Date:  2011-07-26     Revised Date:  2011-09-21    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  802-7     Citation Subset:  AIM; IM    
Affiliation:
Intensive Care Unit, University Hospital of Geneva, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Fluid Therapy / methods*
Follow-Up Studies
Humans
Male
Middle Aged
Monitoring, Intraoperative
Oximetry / methods
Oxygen / blood*
Oxygen Consumption / physiology*
Prognosis
Prospective Studies
ROC Curve
Shock, Cardiogenic / blood*,  therapy
Chemical
Reg. No./Substance:
7782-44-7/Oxygen
Comments/Corrections
Comment In:
J Trauma. 2011 Apr;70(4):1014-5; author reply 1015-6   [PMID:  21610407 ]
J Trauma. 2011 Aug;71(2):518-9; author reply 519-20   [PMID:  21825955 ]

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