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  • Poster presentation
  • Open Access

Prognosis value of dynamic variation of tissue oxygen saturation during severe cardiogenic shock

  • 1,
  • 1,
  • 1 and
  • 1
Critical Care201115 (Suppl 1) :P37

https://doi.org/10.1186/cc9457

  • Published:

Keywords

  • Adult Patient
  • Emergency Medicine
  • Good Prognosis
  • Oxygen Saturation
  • Cardiogenic Shock

Introduction

To evaluate the prognosis value of dynamic thenar O2 saturation (StO2) response using a vascular occlusion test (VOT) during cardiogenic shock.

Methods

A retrospective clinical observational analysis was performed on adult patients treated for severe cardiogenic shock in a surgical ICU. The non-invasive InSpectra near-infrared spectrometer was used to assess the effect of VOT on thenar eminence StO2. The VOT manoeuvre was repeated within the first 24 hours of admission. StO2 VOT-induced changes were compared between surviving and nonsurviving patients between the first 8 hours and the next 16 hours.

Results

Ten patients suffering from cardiogenic shock (age 59.8 ± 13.8 years; APACHE score 21.3 ± 5.9) were treated with inotropes (n = 7) and/or circulatory mechanical assistance (four IABP, three ELS, one LVAD) and vasopressors (n = 9). Mortality in the ICU was 50%. Hemodynamic and metabolic parameters were not different between survivors and nonsurvivors (Table 1). The post-VOT StO2 recovery slope tended to be faster within the first 8 hours in survivors than in nonsurvivors (2.8 ± 1.1 vs. 1.7 ± 0.4%/s, P = 0.09) and improved significantly in the H8 to H24 period (4.5 ± 1.2 vs. 2 ± 1.1%/s, P = 0.007). The post-VOT StO2 recovery slope increased significantly within the first 24 hours in all survivors (Figure 1).
Table 1

Hemodynamic parameters within the first 8 hours in the ICU

 

Survivors

Nonsurvivors

P value

MAP

85

70

0.08

CI

2.4

2.3

1

ScvO2

65

57

0.45

Lactate

4.4

8

0.47

StO2

77

81

0.35

Figure 1
Figure 1

StO 2 recovery slope (mean).

Conclusions

Our results suggest that, in patients treated for cardiogenic shock, rapid improvement in the post-VOT StO2 recovery slope is associated with a better prognosis.

Authors’ Affiliations

(1)
CHRU, Montpellier, France

Copyright

© Gaudard et al. 2011

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.

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