原创力文档high mixed venous oxygen saturation levels do not exclude fluid responsiveness in critically ill septic patients高混合静脉氧饱和度水平不排除在重症败血症的病人对液体的反应.pdfVIP
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high mixed venous oxygen saturation levels do not exclude fluid responsiveness in critically ill septic patients高混合静脉氧饱和度水平不排除在重症败血症的病人对液体的反应
Velissaris et al. Critical Care 2011, 15:R177
/content/15/4/R177
RESEARCH Open Access
High mixed venous oxygen saturation levels do
not exclude fluid responsiveness in critically ill
septic patients
*
Dimitrios Velissaris, Charalampos Pierrakos, Sabino Scolletta, Daniel De Backer and Jean Louis Vincent
Abstract
Introduction: The aim of this study was to determine whether the degree of fluid responsiveness in critically ill
septic patients is related to baseline mixed venous oxygen saturation (SvO2) levels. We also sought to define
whether fluid responsiveness would be less likely in the presence of a high SvO2 (70%).
Methods: This observational study was conducted in a 32-bed university hospital medicosurgical ICU. The
hemodynamic response to a fluid challenge was evaluated in 65 critically ill patients with severe sepsis. Patients
were divided into two groups (responders and nonresponders) according to their cardiac index (CI) response to
the challenge (10% or 10%).
Results: Of the 65 patients, 34 (52%) were fluid responders. Baseline SvO2, CI, heart rate (HR) and mean arterial
pressure (MAP) were not statistically different between groups. The responders had lower pulmonary artery
occlusion pressure (PAOP) and central venous pressure (CVP) at baseline than the nonresponders. After the fluid
challenge, there were no differences between the two groups in MAP, CVP, PAOP or HR. There was no correlation
between changes in CI or stroke volume index and baseline SvO2. Receiver operating characteristic analysis
showed that SvO2 was not a predictor of fluid responsiveness.
Conclusions: The response of septic patients to a fluid challenge is independent of baseline SvO2. The presence of
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