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Volume 17 Supplement 4

Sepsis 2013

  • Poster presentation
  • Open Access

SaO2-SvO2 difference for risk stratification of patients with sepsis and septic shock

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Critical Care201317 (Suppl 4) :P55

https://doi.org/10.1186/cc12955

  • Published:

Keywords

  • Blood Sample
  • Cohort Study
  • Septic Shock
  • Emergency Medicine
  • Risk Stratification

Background

Assessment and monitoring of hemodynamics is a cornerstone in critically ill patients as hemodynamic alteration may become life-threatening in a few minutes [1, 2]. This study aimed to determine whether the SaO2-SvO2 difference could be used as risk stratification for patients with sepsis and septic shock.

Materials and methods

A retrospective cohort study conducted in the ICU of Hospital Santa Luzia, Brasilia, DF, Brazil, during 6 months. An arterial blood sample was collected at admission. Patients with sepsis were divided in two groups: survivors group (SG) and nonsurvivors group (NSG). The accuracy of SaO2-SvO2 difference to predict ICU mortality was measured with the area under the receiver operating characteristic curve.

Results

A total of 131 patients with sepsis were enrolled, 11.5% (n = 15) with septic shock. Age was 66 ± 21 years, SAPS3: 37 ± 17, APACHE II: 14 ± 8, PaO2/FiO2: 342 ± 142 and SaO2/FiO2: 347 ± 109. ICU mortality was 18% (n = 23). The main sites of infections were respiratory (56.5%, n = 74), urinary (19%, n = 25) and cutaneous (7.6%, n = 10). Nonsurvivor patients had higher SaO2-SvO2 difference (26 ± 9 vs. 19 ± 9, P = 0.03). In the group of patients with septic shock, SaO2-SvO2 difference was also higher in nonsurvivors (29 ± 3 vs. 10 ± 2, P = 0.02). All patients with septic shock who died had SaO2-SvO2 difference greater than 25%. The SaO2-SvO2 difference area under ROC curve was 0.714 (95% CI 0.534 to 0.894).

Conclusions

A higher SaO2-SvO2 difference is associated with mortality in patients with sepsis, especially in patients with septic shock.

Authors’ Affiliations

(1)
Escola Superior de Ciências da Saúde, Brasília, Brazil
(2)
Liga Acadêmica de Medicina Intensiva de Brasília, Brazil
(3)
Hospital Santa Luzia, Brasília, Brazil

References

  1. Gattinoni L, Carlesso E: Supporting hemodynamics: what should we target? What treatments should we use?. Crit Care. 2013, 17: S4-10.1186/cc11502.PubMed CentralView ArticlePubMedGoogle Scholar
  2. Rosário AL, Park M, Brunialti MK, Mendes M, Rapozo M, Fernandes D, Salomão R, Laurindo FR, Schettino GP, Azevedo LC: SvO(2)-guided resuscitation for experimental septic shock: effects of fluid infusion and dobutamine on hemodynamics, inflammatory response, and cardiovascular oxidative stress. Shock. 2011, 36: 604-612. 10.1097/SHK.0b013e3182336aa4.View ArticlePubMedGoogle Scholar

Copyright

© Amorim et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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