Near-infrared spectroscopy during stagnant ischemia: a marker of ScvO2–SvO2 mismatch in septic patients with low cardiac output

H Mozina,M Podbregar

doi:10.1186/cc6293

Abstract

Monitoring of oxygen saturation in the superior vena cava (ScvO2) was suggested as a simpler and cheaper assessment of the global DO2:VO2 ratio and was used successfully as a goal in treatment of patients with septic shock and severe sepsis [1]. In patients with low cardiac output (CO) the difference between SvO2 and ScvO2 is more expressed and problematically large confidence limits and poor correlation were found between the two values [2]. The thenar muscle oxygen saturation (StO2) measured with near-infrared spectroscopy (NIRS) during stagnant ischemia (cuff inflation-induced vascular occlusion) decreases slower in septic shock patients [3]. This may be due to slower muscle tissue oxygen consumption in sepsis. This phenomenon possibly contributes to the ScvO2–SvO2 mismatch in patients with low CO by adding more oxygenated venous blood to flow through the superior vena cava. The aim of present study was to determine the relationship between the StO2 deceleration rate and the ScvO2–SvO2 difference in septic patients with low CO.

Highlights

The aim of this study was to elucidate the impact of ICU-acquired infection on ICU and hospital mortality
The goal from this study is to evaluate weaning predictor indexes in patients during weaning from mechanical ventilation (MV)
This study aims to evaluate the effects of the threshold in such situations

Summary

Introduction

The aim of this study was to elucidate the impact of ICU-acquired infection on ICU and hospital mortality. Methods A total of 48 community patients (36 men, 11 women, age 50.17 ± 17.974 years, APACHE II score 13.51 ± 6.153) who were expected to stay in the ICU for >5 days were included in this study. Specific examples of feedback are as follows: ‘good update of management plan reinforces need for taking into account concurrent medication when resuscitating patients’, ‘nice simple messages with good starting points for trying to deal with these complicated patients’, ‘useful data on risk of recurrence as this is a question often asked by patients’ This feedback was encouraging as it showed how the primary care professionals planned to change their practice to improve patient outcomes as a result of the learning. The course was considered excellent by 63% of the participants and good by 36%

Methods

Results

Conclusion