Patterns of central venous oxygen saturation,lactate and veno-arterial CO2 difference in patients with septic shock |
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| Authors: | Rubina Khullar Mahajan John Victor Peter George John Petra L. Graham Shoma V. Rao Michael R. Pinsky |
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| Affiliation: | From: Medical Intensive Care Unit, Division of Critical Care Medicine, Christian Medical College, Vellore, Tamil Nadu, India;1Department of Statistics, Macquarie University, Sydney, Australia;2Surgical Intensive Care Unit, Division of Critical Care Medicine, Christian Medical College, Vellore, Tamil Nadu, India;3Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA |
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| Abstract: | Results:Of the 104 patients with circulatory shock, 79 patients (44 males) with septic shock aged 49.8 (standard deviation ± 14.6) years and with sequential organ failure assessment (SOFA) score of 11.0 ± 3.4 were included. 71 patients (89.9%) were ventilated (11.4 ± 12.3 ventilator-free days). The duration of hospitalization was 16.6 ± 12.8 days and hospital mortality 50.6%. Lactate significantly decreased over time with a greater decrement in survivors than nonsurvivors (−0.35 vs. −0.10, P < 0.001). For every l/min increase in cardiac output, vaCO2 decreased by 0.34 mmHg (P = 0.006). There was no association between ScvO2 and mortality (P = 0.930). 0 h SOFA and vaCO2 ≤6 mmHg were strongly associated (P = 0.005, P = 0.018, respectively) with higher odds of mortality. However, this association was evident only in those with ScvO2 >70% and not in ScvO2 ≤70%.Conclusion:In septic shock, vaCO2 ≤6 mmHg is independently associated with mortality, particularly in those with normalized ScvO2 consistent with metabolic microcirculatory abnormalities in these patients. |
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| Keywords: | Metabolic microcirculation outcome resuscitation septic |
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