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The review by Nguyen et al. [1] acknowledges the substantially lower baseline central venous oxygen saturation (ScvO2) values reported by Rivers et al. [2] (48.6 ± 11.2 %) when compared to those for ProCESS [3] (71 ± 13 %), ARISE [4] (72.7 ± 10.5 %) and ProMISe [5] (64 ± 20 %) trials. Assuming normality, the distribution of baseline ScvO2 values in the study by Rivers et al. differed from those of the other trials (Fig. 1; p < 0.0001 by t test). Nguyen et al. ascribed this difference to “earlier central venous catheter (CVC) placement, greater shock severity or imbalances between O2 delivery and O2 consumption before corrective interventions”.

Work of breathing, not dysoxia, as the cause of low central venous blood O2 saturation in sepsis