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

Abstract

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.

Low values of central venous oxygen saturation (ScvO2) during surgery and anastomotic leak of abdominal trauma patients

“…Other authors have found similar results [10, 11, 20–25]. Hoshking et al showed that levels of 66.5% or lower of ScvO 2 are associated with a worst outcome despite a stable hemodynamic state [15]. Pearse et al described the changes in ScvO 2 after mayor surgery finding an independent association between levels of ScvO 2 (with a cut point of 65%) and the development of POP complications [11].…”

“…Based on the results from this study, ScvO 2 monitoring during surgery could be a potential and easily available hypoperfusion marker. It is important to mention that values of ScvO 2 may reflect a low oxygen extraction rate secondary to mitochondrial impairment indicating poor outcomes and limits low levels of ScvO 2 sensibility [15, 33, 34]. …”

“…It has been proved that ScvO 2 levels vary according to the catheter’s point location [35]; therefore, it is important to note that the sample was taken from the superior vena cava so measurements could be affected by brain metabolism, specially under anesthesia. Other potential marker is serum lactate, but it was not measured for this study as it can vary in different conditions such as fluid replacement with Ringer lactate [15–18], a common practice in trauma patients. Other limitations of this study were the sample size for the study and that ScvO 2 values were not measured continuously.…”

“…Tissue hypoperfusion results from circulatory disturbances during hypoxic and hemorrhagic periods, and evidence suggests that ScvO 2 reflects the early stages of hypoperfusion [6, 11–15]. Other hypoperfusion marker is lactic acid, which is elevated during low tissue oxygenation even under normal vital signs.…”

“…Other hypoperfusion marker is lactic acid, which is elevated during low tissue oxygenation even under normal vital signs. Nevertheless, lactic acid could be elevated by different circumstances like hepatic impairment as well as those treated with Ringer lactate [15–18]. ScvO 2 , being an early hypoperfusion marker, could support early and objective decision-making during surgical procedure.…”