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Controversy remains regarding the relationship between central venous saturation (ScvO 2 ) and mixed venous saturation (SvO 2 ) and their use and interchangeability in patients with sepsis or septic shock. We tested the hypothesis that ScvO 2  does not reliably predict SvO 2  in sepsis. Additionally we looked at the influence of the source (splanchnic or non-splanchnic) of sepsis on this relationship.    Methods  In this prospective observational two-center study we concurrently determined ScvO 2  and SvO 2  in a group of 53 patients with severe sepsis during the first 24 hours after admission to the intensive care units in 2 Dutch hospitals. We assessed correlation and agreement of ScvO 2  and SvO 2 , including the difference, i.e. the gradient, between ScvO 2  and SvO 2  (ScvO 2  - SvO 2 ). Additionally, we compared the mean differences between ScvO 2  and SvO 2  of both splanchnic and non-splanchnic group.    Results  A total of 265 paired blood samples were obtained. ScvO 2  overestimated SvO 2  by less than 5% with wide limits of agreement. For changes in ScvO 2  and SvO 2  results were similar. The distribution of the (ScvO 2  - SvO 2 ) (< 0 or ≥ 0) was similar in survivors and nonsurvivors. The mean (ScvO 2  - SvO 2 ) in the splanchnic group was similar to the mean (ScvO 2  - SvO 2 ) in the non-splanchnic group (0.8 ± 3.9% vs. 2.5 ± 6.2%;  P  = 0.30). O 2 ER ( P  = 0.23) and its predictive value for outcome ( P  = 0.20) were similar in both groups.    Conclusions  ScvO 2  does not reliably predict SvO 2  in patients with severe sepsis. The trend of ScvO 2  is not superior to the absolute value in this context. A positive difference (ScvO 2  - SvO 2 ) is not associated with improved outcome.

No agreement of mixed venous and central venous saturation in sepsis, independent of sepsis origin