Premium
Central venous oxygen saturation for the diagnosis of low cardiac output in septic shock patients
Author(s) -
PERNER A.,
HAASE N.,
WIIS J.,
WHITE J. O.,
DELANEY A.
Publication year - 2010
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2009.02086.x
Subject(s) - medicine , septic shock , pulmonary artery catheter , central venous catheter , intensive care , confidence interval , superior vena cava , prospective cohort study , cardiac output , observational study , shock (circulatory) , cardiac surgery , anesthesia , cardiology , sepsis , early goal directed therapy , cardiac index , catheter , surgery , hemodynamics , intensive care medicine , severe sepsis
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 ≥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 ≥64% indicated CI TD >2.5 l/min/m 2 in ICU patients with septic shock.