Service d'anesthésie et de réanimation, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Université de la Méditerranée, Chemin des bourrely, 13915 Marseille Cedex 20, France.
Crit Care. 2011 Jul 26;15(4):R176. doi: 10.1186/cc10325.
Current guidelines recommend maintaining central venous oxygen saturation (ScvO2) higher than 70% in patients with severe sepsis and septic shock. As high levels of ScvO2 may reflect an inadequate use of oxygen, our aim was to evaluate the relation between maximal ScvO2 levels (ScvO2max) and survival among intensive care unit (ICU) patients with septic shock.
We retrospectively analyzed data from all admissions to our ICU between January 2008 and December 2009. All septic shock patients in whom the ScvO2 was measured were included. The measures of ScvO2max within the first 72 hours after the onset of shock were collected.
A total of 1,976 patients were screened and 152 (7.7%) patients met the inclusion criteria. The level of ScvO2max was 85% (78 to 89) in the non-survivors, compared with 79% (72 to 87) in the survivors (P = 0.009).
Our findings raise concerns about high levels of ScvO2 in patients with septic shock. This may reflect the severity of the shock with an impaired oxygen use. Future strategies may target an optimization of tissue perfusion in this specific subgroup of patients.
目前的指南建议严重脓毒症和感染性休克患者保持中心静脉血氧饱和度（ScvO2）高于 70%。由于 ScvO2 水平较高可能反映出氧利用不足，因此我们旨在评估 ICU 感染性休克患者的最大 ScvO2 水平（ScvO2max）与生存率之间的关系。
我们回顾性分析了 2008 年 1 月至 2009 年 12 月期间所有入住 ICU 的患者的数据。所有测量 ScvO2 的感染性休克患者均被纳入研究。收集休克发生后 72 小时内 ScvO2max 的测量值。
共筛选了 1976 名患者，其中 152 名（7.7%）患者符合纳入标准。非幸存者的 ScvO2max 水平为 85%（78%至 89%），而幸存者为 79%（72%至 87%）（P=0.009）。
我们的研究结果对感染性休克患者的 ScvO2 水平较高表示担忧。这可能反映了休克的严重程度和氧利用受损。未来的策略可能针对这一特定亚组患者的组织灌注进行优化。
