Prognosis value of central venous oxygen saturation in acute decompensated heart failure

Gallet, Romain; Lellouche, Nicolas; Mitchell-Heggs, Laurens; Bouhemad, Bélaïd; Bensaïd, Alexandre; Dubois‐Randé, Jean‐Luc; Guéret, Pascal; Lim, Pascal

doi:10.1016/j.acvd.2011.10.005

Cited by 30 publications

(24 citation statements)

References 22 publications

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“…2,9,12,[20][21][22][23][24][28][29][30]40,42,47 In patients undergoing abdominal surgery, ScvO 2 below 70-75% was associated with increased morbidity. The main results of our study were that values of SmvO 2 or ScvO 2 below 55-70% in cardiac patients and in patients admitted to general ICUs were associated with increased mortality, morbidity and length of stay in ICU.…”

Section: Discussionmentioning

confidence: 99%

“…The main results of our study were that values of SmvO 2 or ScvO 2 below 55-70% in cardiac patients and in patients admitted to general ICUs were associated with increased mortality, morbidity and length of stay in ICU. 2,9,12,[20][21][22][23][24][28][29][30]40,42,47 In patients undergoing abdominal surgery, ScvO 2 below 70-75% was associated with increased morbidity. [31][32][33]37,46 Lower survival was also observed in patients with septic shock with SmvO 2 below 65% and ScvO 2 below 60-70% or above 80%.…”

Section: Discussionmentioning

confidence: 99%

“…19,27,43 Association between SvO 2 and morbidity Several studies have furthermore investigated the association between low SvO 2 and morbidity. 20,21,30,42 Consequently, a low SmvO 2 and ScvO 2 has in the majority of studies been associated with increased use of post-operative ventilatory support and increased length of stay in the ICU. Morbidity was seen as increased rates of post-operative stroke, organ dysfunction and major adverse cardiac events.…”

Section: Association Between Svo 2 and Mortalitymentioning

confidence: 99%

“…Morbidity was seen as increased rates of post-operative stroke, organ dysfunction and major adverse cardiac events. 20,21,30,42 Consequently, a low SmvO 2 and ScvO 2 has in the majority of studies been associated with increased use of post-operative ventilatory support and increased length of stay in the ICU. 24,29,40,47 Similar observations have been done in patients undergoing abdominal surgery, although the cut-off values for ScvO 2 were consistently higher than for those in cardiac surgery.…”

Section: Association Between Svo 2 and Morbiditymentioning

confidence: 99%

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Systematic review of the association of venous oxygenation and outcome in adult hospitalized patients

Chemtob

Eskesen

Moeller-Soerensen

et al. 2016

Acta Anaesthesiol Scand

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Low venous oxygen saturation may be associated with increased mortality, morbidity and length of intensive care in patients following cardiac or abdominal surgery. However, the wide range of cut-off levels and low quality of evidence hampers the clinical application. In patients with septic shock, the present evidence does not support goal-directed therapy using venous oxygen saturation during early resuscitation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Association Between Svo 2 and Mortalitymentioning

confidence: 99%

Section: Association Between Svo 2 and Morbiditymentioning

confidence: 99%

See 2 more Smart Citations

Systematic review of the association of venous oxygenation and outcome in adult hospitalized patients

Chemtob

Eskesen

Moeller-Soerensen

et al. 2016

Acta Anaesthesiol Scand

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“…In order to maintain tissue oxygenation, SvO 2 has been used as a marker to assess the adequacy of the circulation [7] in cardiac surgery patients but, there are rather few studies describing continuous SvO 2 monitoring during TAVR procedures [8] [9]. Low SvO 2 values were associated with higher morbidity and mortality after cardiac surgery [10] [11] [12]. In the study of Holm et al, [13]…”

Section: Introductionmentioning

confidence: 99%

Mixed Venous Oxygen Saturation during the Transcatheter Aortic Valve Replacement—A Prospective Cohort Study

Musialowicz¹,

Ellam²,

Valtola³

et al. 2019

OJAnes

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Purpose: Patients scheduled to undergo the transcatheter aortic valve replacement (TAVR) are usually octogenarians with severe co-morbidities and an increased risk of surgery-associated complications. The aim of this study was to determine the incidence of insufficient oxygen delivery as measured by mixed venous oxygen saturation (SvO 2 ) via invasive continuous cardiopulmonary monitoring and the low cardiac output syndrome (LCOS) in patients undergoing the TAVR procedure. The second objective was to examine how these hemodynamic measurements would change during critical events, such as rapid ventricular pacing (RVP) during this procedure. Methods: This prospective, observational study, examined twenty patients undergoing TAVR under general anesthesia. Hemodynamic variables, SvO 2 and the continuous cardiac output (CO) were assessed using pulmonary artery catheter (PAC) and a Vigilance ® monitor. Insufficient oxygen delivery was defined as a SvO 2 value under 58% and LCOS as a cardiac index (CI) under 2 L/min/m 2 . Total intravenous anesthesia and hemodynamic management protocol were standardized. RVP was induced twice during the procedure at a frequency of 180 -200/min. Predefined clinical endpoints were assessed during the procedure and hemodynamic values were analyzed before and after twelve critical events. Results: The data of twenty patients with a mean age of 80 ± 4 years and EuroSCORE 18 ± 10 were analyzed. Fourteen (70%) of the TAVR procedures were performed transapically, the other six (30%) transfemorally. The SvO 2 value under 58% (mean 54 ± 6) and the CI under 2 L/min/m 2 (mean 1.6 ± 0.2) were detected in 60% of patients (n = 12) before the use of RVP. All of these patients received perioperative inotropic medication and required norepinephrine infusion for maintenance of adequate blood pressure. The SvO 2 , CO and CI were significantly decreased after the use of RVP (P < 0.001 and P < 0.03). The SvO 2 reverted rapidly to the same level as before the application How to cite this paper: Musialowicz, T., Ellam, S., Valtola, A., Halonen, J. and Lahtinen, P. (2019) Mixed Venous Oxygen Saturation during the Transcatheter Aortic Valve Replacement-A Prospective Cohort Study. Open Journal of Anesthesiology,9,[140][141][142][143][144][145][146][147][148][149][150][151][152][153] of RVP (1 min), CO, and CI 10 min later. At the end of the operation SvO 2 values were at same level as before RVP and CO and CI were higher than before RVP. Conclusion: A high incidence of insufficient oxygen delivery and low cardiac output syndrome were detected in patients undergoing TAVR procedures. Nonetheless, all hemodynamic values returned rather rapidly to the same level as before the use of the RVP and were at the optimal level at the end of the procedure. According to the current study, the most hemodynamically hazardous steps during TAVR are the use of RVP sequences, the induction of anesthesia and the initiation of surgery.

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Controlled decongestion by Reprieve therapy in acute heart failure: results of the TARGET‐1 and TARGET‐2 studies

Biegus

Zymliński

Siwołowski

et al. 2019

European J of Heart Fail

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Aims Safe and effective decongestion is the main goal of therapy in acute heart failure (AHF). In the non‐randomized, prospective TARGET‐1 and TARGET‐2 studies (NCT03897842), we investigated whether adding the Reprieve System® (which continuously monitors urine output and delivers a matched volume of hydration fluid sufficient to maintain the set fluid balance rate) to standard diuretic‐based regimen improves decongestion in AHF. Methods and results The population consisted of 19 patients hospitalized with AHF (mean age 67 ± 10 years, 18 male, ejection fraction 34 ± 15%, median N‐terminal pro‐B‐type natriuretic peptide 4492 pg/mL). Patients served as their own controls: each patient underwent 24 h of standard diuretic therapy followed by 24 h of diuretics with Reprieve therapy (with normal saline used for matched volume replacement). The primary efficacy endpoint of actual fluid loss not exceeding the target fluid loss at the end of therapy was met in all 19 (100%) patients. The mean diuresis during Reprieve therapy was 6284 ± 2679 mL (vs. 1966 ± 1057 mL 24 h before therapy) and 2053 ± 888 mL (24 h after therapy) (both P < 0.0001). At the end of therapy, patient global assessment improved from 7.7 ± 1.1 to 3.0 ± 1.3 points (P < 0.001), central venous pressure decreased from 15.5 ± 5.3 mmHg to 12.8 ± 4.8 mmHg (P < 0.05) and the median urine sodium loss was 9.7 [3–13] mmol/h. The Reprieve therapy was safe, systolic blood pressure remained stable, mean creatinine dropped from 1.45 ± 0.4 mg/dL to 1.26 ± 0.4 mg/dL (P < 0.001) and biomarkers of renal injury did not change during treatment. Conclusions The Reprieve System in conjunction with diuretic therapy supports safe and controlled decongestion in AHF.

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Prognosis value of central venous oxygen saturation in acute decompensated heart failure

Abstract: In patients admitted for ADHF requiring inotrope support, ScvO2≤60% despite optimal treatment is a marker of poor outcome and might be an indicator for considering more aggressive therapy.

Cited by 30 publications

References 22 publications

Systematic review of the association of venous oxygenation and outcome in adult hospitalized patients

Systematic review of the association of venous oxygenation and outcome in adult hospitalized patients

Mixed Venous Oxygen Saturation during the Transcatheter Aortic Valve Replacement—A Prospective Cohort Study

Controlled decongestion by Reprieve therapy in acute heart failure: results of the TARGET‐1 and TARGET‐2 studies

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