Should we use central venous saturation to guide management in high-risk surgical patients 英文参考文献.docVIP

Available online /content/10/6/181 Commentary Should we use central venous saturation to guide management in high-risk surgical patients? Rupert M Pearse and Charles J Hinds Barts and The London School of Medicine and Dentistry, Queen Mary’s University of London, 5th floor, 38 Little Britain, St. Bartholomew’s Hospital, London EC1A 7BE, UK Corresponding author: Rupert Pearse, rupert.pearse@bartsandthelondon.nhs.uk Published: 15 December 2006 Critical Care 2006, 10:181 (doi:10.1186/cc5122) This article is online at /content/10/6/181 ? 2006 BioMed Central Ltd See related research by The Collaborative Study Group on Perioperative ScvO2 Monitoring, /content/10/6/R158 Abstract monitoring can be performed in any patient with a central venous catheter. However, it is not yet clear whether ScvO2 measurement through intermittent blood sampling is an adequate alternative to continuous monitoring with a fibre- optic catheter. Interest in ScvO2 measurement is not new, and several reports have explored the physiology and clinical significance of this parameter over the past 50 years [3]. Of these, the work of Rivers and colleagues [4] has proved the most influential. These authors used a ScvO2 value of 70% as a target for goal-directed haemodynamic therapy (GDT) in patients presenting to hospital with severe sepsis and septic shock. They demonstrated that it may be possible to achieve substantial mortality reductions without the need for complex Measurements of central venous oxygen saturation (ScvO2) have been successfully used to guide haemodynamic therapy in critical care. The efficacy of this approach in the treatment of severe sepsis and septic shock has stimulated interest in the use of ScvO2 to guide management in patients undergoing major surgery. The physiological basis of ScvO measurement is complex. A 2 number of outstanding issues will need to be