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Accurate and rapid measurement of pathophysiological derangements is crucial in order to intervene early and effectively. Measurement of various parameters has not only become possible but also precise, fast, and in some cases continuous. However, improved technology has brought with it increasing monitoring and treatment costs that has resulted in critical care practice becoming less affordable, particularly in developing countries such as ours. Thus the article in this issue of the Indian Journal of Critical Care Medicine (IJCCM), by Subramanian et al.,[1] is relevant. In this study,[1] the authors compared central venous saturation by standard arterial blood gas (ABG) with saturation obtained by cooximetry. Patients with different clinical conditions that are known to shift the oxygen dissociation curve and thus influence calculated oxygen saturation were included. The authors reported a sensitivity of 84.2% and specificity of 93.2% for central venous oxygen saturation (ScVO2) with the use of standard ABG against cooximetry. They concluded that “standard ABG can be a satisfactory and cost-effective surrogate for the more expensive cooximetry when assessing ScVO2 for patients with shock.”

Can calculated central venous saturation be used as a reliable tool to guide therapy in patients with shock?