ScvO2 As a Marker to Define Fluid Responsiveness.
Summary of "ScvO2 As a Marker to Define Fluid Responsiveness."
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 (DeltaScvO2 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 (SvO2) and ScvO2 were measured before and after VE. CI, SvO2, and ScvO2 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:
: DeltaScvO2 and SvO2 variations after VE (DeltaSvO2) were significantly correlated with CI changes (DeltaCI) after VE (r = 0.67 and r = 0.49, p < 0.001, respectively). A DeltaScvO2 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.
Affiliation
From the Intensive Care Unit (R.G., N.S., J-A.R., K.B.), University Hospital of Geneva, Switzerland; Division of Biostatistics (A.G-A., C.C.), University Hospital of Geneva, Switzerland; and Department of Clinical Research (C.C.), University of Geneva, Sw
Journal Details
This article was published in the following journal.
Name: The Journal of trauma
ISSN: 1529-8809
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20805770
- DOI: http://dx.doi.org/10.1097/TA.0b013e3181e7d649
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