10 Jan 07

Incidence of low central venous oxygen saturation during unplanned admissions in a multidisciplinary ICU

Posted in ScvO2 at 19:47 by Laci

By H Bracht, M Haenggi, B Jeker, N Wegmueller, F Porta, D Tueller, J Takala and S M Jakob

Critical Care 2007, 11:R2

It has been shown that early central venous oxygen saturation (ScvO₂)-guided optimization of hemodynamics can improve outcome in septic patients. The early ScvO₂ profile of other patient groups is unknown. The aim of this study was to characterize unplanned admissions in a multidisciplinary intensive care unit (ICU) with respect to ScvO₂ and outcome.

Methods
98 consecutive unplanned admissions to a multidisciplinary intensive care unit [age: 63 (19 to 83) years (median, range), acute simplified physiology score (SAPS II): 43 (11 to 93)] with a clinical indication for a central venous catheter were included in the study. ScvO₂ was assessed at ICU arrival and 6 hours later, but was not used to guide treatment. Length of stay in ICU (LOSICU) and hospital (LOShospital) and 28-day mortality were recorded.

Results
ScvO₂ was 70 +/- 12% (mean +/- SD) at admission and 71 +/- 10% 6 hours later (p: 0.484). Overall 28-day mortality was 18%, LOSICU was 3 (1 to 28) days and LOShospital was 19 (1 to 28) days. Patients with ScvO₂ <60% at admission had higher mortality than patients with ScvO2 >60% (29 vs. 17%, p<0.05). Changes in ScvO₂ during the first 6 hours were not predictive of LOSICU, LOShospital or mortality.

Conclusions
Low ScvO₂ in unplanned admissions and high SAPS II scores are associated with increased mortality. Standard ICU treatment increased ScvO₂ in patients with a low admission ScvO_<2, but the increase was not associated with length of stay in ICU or in hospital.

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