ScvO2Central Venous Oxygen Saturation
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Peripheral perfusion (76%), CVP (36%), sustained CVP (30%), ScvO2 (18%), MVO2 (11%), Cardiac Output/Index (CO/CI) (18%), sonography (6%), pulse pressure variability (6%) and lactic acid measure (4%) were used less frequently either often or always (Figure 1).
Forty-four percent of physicians reported using a RBC transfusion threshold of 7g/dL if the ScvO2 was 50% in a patient who had reduced metabolic demand and optimized intravascular volume and blood pressure, while 11% used a threshold of 10g/dL.
More invasive techniques such as intra-arterial lines CVP, ScvO2, MVO2, and CO/CI are only seldom used.
Compared with group C, CVP, ScvO2 and MAP were higher at T2, but blood lactate content was lower at T2.
Meanwhile, ScvO2 at T2 of group G increased obviously higher than that of group C, and the content of blood lactic acid in group G decreased evidently, which might confirm the above inference.
Thus it can be seen that the difference of ScvO2 and blood lactic acid content between the two groups showed that the GDFT guided by NICOM was more conducive to maintain the balance of oxygen supply and demand to improve microcirculation.
Nearly half of those patients were treated through an aggressive intervention method called Early Goal-Directed Therapy (EGDT) using a catheter from Edwards Lifesciences Corporation (Irvine, CA; 949-250-6826) capable of continuously measuring a patient's ScvO2. Low ScvO2 is a key indicator of the blood oxygen imbalance associated with severe sepsis and septic shock, which can contribute significantly to multiple organ failure and death.
Rivers, who led the study, which builds on earlier work by Professor Konrad Reinhart of the University of Jena (Germany), showing the value of ScvO2 measurement as a diagnostic tool.