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Low central venous oxygen saturation in haemodynamically stabilized trauma patients is associated with poor outcome.

Hosking, C; Wilander, P; Goosen, J; Jacobson, H; Moeng, M; Boffard, K and Bentzer, Peter LU (2011) In Acta Anaesthesiologica Scandinavica 55. p.713-721
Abstract
Background: Central venous oxygen saturation (ScvO(2) ) is suggested to reflect the adequacy of oxygen delivery, and the main objective of the present study was to determine whether ScvO(2) is associated with outcome in haemodynamically stabilized trauma patients. Methods: Haemodynamically unstable trauma patients receiving a central venous line within 1 h of admission were eligible for inclusion in this prospective observational study. The mean arterial pressure (MAP), lactate and ScvO(2) were recorded at inclusion and every 6 h for 36 h or until lactate was <2.0 mmol/l and ScvO(2) was >75% in two consecutive measurements. Patients with a MAP of ≥70 mmHg were considered to be haemodynamically stabilized. The outcome measure was... (More)
Background: Central venous oxygen saturation (ScvO(2) ) is suggested to reflect the adequacy of oxygen delivery, and the main objective of the present study was to determine whether ScvO(2) is associated with outcome in haemodynamically stabilized trauma patients. Methods: Haemodynamically unstable trauma patients receiving a central venous line within 1 h of admission were eligible for inclusion in this prospective observational study. The mean arterial pressure (MAP), lactate and ScvO(2) were recorded at inclusion and every 6 h for 36 h or until lactate was <2.0 mmol/l and ScvO(2) was >75% in two consecutive measurements. Patients with a MAP of ≥70 mmHg were considered to be haemodynamically stabilized. The outcome measure was complications defined as infections, delta sequential organ failure assessment score of >0, and mortality. Results: Fifty patients with a median new injury severity score of 27 (17-34) were analysed. Complications occurred in 33 patients. An association between ScvO(2) following resuscitation to MAP ≥70 mmHg and complications was detected with an odds ratio of 0.94 (95% confidence interval; 0.89-0.99). This association was also significant when adjusted for injury severity. The result implies that a low ScvO(2) value is associated with more complications. The optimal cut-off for ScvO(2) to discriminate between patients who did or did not develop complications was found to be 66.5% (56-86%). Conclusions: These data suggest that low ScvO(2) in haemodynamically stabilized patients is associated with a poor outcome and that ScvO(2) represents a potential endpoint of resuscitation in trauma patients. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
55
pages
713 - 721
publisher
Wiley-Blackwell
external identifiers
  • WOS:000292100800014
  • PMID:21615345
  • Scopus:80955177505
ISSN
0001-5172
DOI
10.1111/j.1399-6576.2011.02457.x
language
English
LU publication?
yes
id
efd2cf7c-4dd7-4b35-b004-38bfca78ae35 (old id 1972147)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21615345?dopt=Abstract
date added to LUP
2011-06-07 22:36:57
date last changed
2016-12-04 04:36:55
@misc{efd2cf7c-4dd7-4b35-b004-38bfca78ae35,
  abstract     = {Background: Central venous oxygen saturation (ScvO(2) ) is suggested to reflect the adequacy of oxygen delivery, and the main objective of the present study was to determine whether ScvO(2) is associated with outcome in haemodynamically stabilized trauma patients. Methods: Haemodynamically unstable trauma patients receiving a central venous line within 1 h of admission were eligible for inclusion in this prospective observational study. The mean arterial pressure (MAP), lactate and ScvO(2) were recorded at inclusion and every 6 h for 36 h or until lactate was &lt;2.0 mmol/l and ScvO(2) was &gt;75% in two consecutive measurements. Patients with a MAP of ≥70 mmHg were considered to be haemodynamically stabilized. The outcome measure was complications defined as infections, delta sequential organ failure assessment score of &gt;0, and mortality. Results: Fifty patients with a median new injury severity score of 27 (17-34) were analysed. Complications occurred in 33 patients. An association between ScvO(2) following resuscitation to MAP ≥70 mmHg and complications was detected with an odds ratio of 0.94 (95% confidence interval; 0.89-0.99). This association was also significant when adjusted for injury severity. The result implies that a low ScvO(2) value is associated with more complications. The optimal cut-off for ScvO(2) to discriminate between patients who did or did not develop complications was found to be 66.5% (56-86%). Conclusions: These data suggest that low ScvO(2) in haemodynamically stabilized patients is associated with a poor outcome and that ScvO(2) represents a potential endpoint of resuscitation in trauma patients.},
  author       = {Hosking, C and Wilander, P and Goosen, J and Jacobson, H and Moeng, M and Boffard, K and Bentzer, Peter},
  issn         = {0001-5172},
  language     = {eng},
  pages        = {713--721},
  publisher    = {ARRAY(0xd113918)},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Low central venous oxygen saturation in haemodynamically stabilized trauma patients is associated with poor outcome.},
  url          = {http://dx.doi.org/10.1111/j.1399-6576.2011.02457.x},
  volume       = {55},
  year         = {2011},
}