Comparison of clinical outcomes between intermittent and continuous monitoring of central venous oxygen saturation (ScvO2) in patients with severe sepsis and septic shock: a pilot study. Issue 11 (8th November 2012)

• Record Type: Journal Article
• Authors: Huh, Jin Won; Oh, Bum Jin; Lim, Chae-Man; Hong, Sang-Bum; Koh, Younsuck
• Is Part Of: Emergency medicine journal. Volume 30:Issue 11(2013)
• Page Start: 906
• Page End: 909
• Publication Date: 2012-11-08
• Subjects: resuscitation, clinical care -- infectious diseases -- respiratory, pneumonia/infections; Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1136/emermed-2012-201356
• Languages: English
• ISSNs: 1472-0205

Abstract

Abstract : Background: The Surviving Sepsis Campaign (SSC) to improve patient outcomes in severe sepsis and septic shock contains recommendations for protocolised resuscitation including early goal-directed therapy (EGDT) resuscitation. In EGDT, central venous oxygen saturation (ScvO2 ) is measured as the target monitoring value. The objective of this study was to determine whether intermittent measurement of ScvO2 is as clinically effective as continuous monitoring in EGDT implementation. Methods: This prospective, observational, pilot study was performed at an emergency room and general ward in ASAN Medical Centre, a 2680-bed teaching hospital. One hundred and six patients with severe sepsis or septic shock were enrolled and assigned to an intermittent monitoring group (n=53) or continuous monitoring group (n=53). Results: Within 6 h of the EGDT, interventions by the treating physicians were assessed, including intravenous fluid administration, use of vasopressors and compliance with SSC bundles. After 6 h of the EGDT, 41.5% of all goals (primary outcome) were achieved in the intermittent group and 35.8% in the continuous group (p=0.550). Intensive Care Unit (ICU) mortality, hospital mortality and length of ICU stay did not differ between groups. Conclusions: During EGDT, intermittent ScvO2 monitoring was not inferior to continuous ScvO2 monitoring when delivered within the first 6 h of intervention.