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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
  1. Jin Won Huh1,
  2. Bum Jin Oh2,
  3. Chae-Man Lim1,
  4. Sang-Bum Hong1,
  5. Younsuck Koh1
  1. 1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
  2. 2Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea
  1. Correspondence to Dr Younsuck Koh, Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-2dong, Songpa-gu, Seoul, South Korea, yskoh{at}amc.seoul.kr

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.

  • resuscitation, clinical care
  • infectious diseases
  • respiratory, pneumonia/infections

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