Combining central venous-to-arterial partial pressure of carbon dioxide difference and central venous oxygen saturation to guide resuscitation in septic shock.

Central venous oxygen saturation (Scvo2) is a useful therapeutic target when treating septic shock. We hypothesized that combining Scvo2 and central venous-to-arterial partial pressure of carbon dioxide difference (△Pco2) may provide additional information about survival. We performed a retrospective analysis of 172 patients treated for septic shock. All patients were treated using goal-directed therapy to achieve Scvo2 ≥ 70%. After 6 hours of treatment, we divided patients into 4 groups based on Scvo2 (<70% or ≥ 70%) and △Pco2 (<6 mm Hg or ≥ 6 mm Hg). Overall, 28-day mortality was 35.5%. For patients in whom the Scvo2 target was not achieved at 6 hours, mortality was 50.0%, compared with 29.5% in those in whom Scvo2 exceeded 70% (P = .009). In patients with Scvo2 ≥ 70%, mortality was lower if △Pco2 was <6 mm Hg than if △Pco2 was ≥ 6 mm Hg (56.1% vs 16.1%, respectively; P < .001) and 6-hour lactate clearance was superior (0.01 ± 0.61 vs 0.21 ± 0.31, respectively; P = .016). The combination of Scvo2 and △Pco2 appears to predict outcome in critically ill patients resuscitated from septic shock better than Scvo2 alone. Patients who meet both targets appear to clear lactate more efficiently.

Du W ，Liu DW ，Wang XT ，Long Y ，Chai WZ ，Zhou X ，Rui X ... -  《-》

[Combination of central venous-to-arterial PCO2 difference with central venous oxygen saturation to guide the shock resuscitation].

DU W ，Liu DW ，Long Y ，Wang XT ，Chai WZ ，Zhou X ，Rui X ... -  《-》

Central venous-to-arterial carbon dioxide partial pressure difference in early resuscitation from septic shock: a prospective observational study.

Mallat J ，Pepy F ，Lemyze M ，Gasan G ，Vangrunderbeeck N ，Tronchon L ，Vallet B ，Thevenin D ... -  《-》

[Comparison of the effect of fluid resuscitation as guided either by lactate clearance rate or by central venous oxygen saturation in patients with sepsis].

Yu B ，Tian HY ，Hu ZJ ，Zhao C ，Liu LX ，Zhang Y ，Zhu GJ ，Wang LT ，Wu XH ，Li J ... -  《-》

Central venous oxygen saturation under non-protocolized resuscitation is not related to survival in severe sepsis or septic shock.

Chung KP ，Chang HT ，Huang YT ，Liao CH ，Ho CC ，Jerng JS ，Yu CJ ... -  《-》