Incidence of low central venous oxygen saturation during unplanned admissions in a multidisciplinary intensive care unit: an observational study.
BACKGROUND
It has been shown that early central venous oxygen saturation (ScvO2)-guided optimization of hemodynamics can improve outcome in septic patients. The early ScvO2 profile of other patient groups is unknown. The aim of this study was to characterize unplanned admissions in a multidisciplinary intensive care unit (ICU) with respect to ScvO2 and outcome.


METHODS
Ninety-eight consecutive unplanned admissions to a multidisciplinary ICU (median age 63 [range 19 to 83] years, median Simplified Acute Physiology Score [SAPS II] 43 [range 11 to 92]) with a clinical indication for a central venous catheter were included in the study. ScvO2 was assessed at ICU arrival and six hours later but was not used to guide treatment. Length of stay in ICU (LOSICU) and in hospital (LOShospital) and 28-day mortality were recorded.


RESULTS
ScvO2 was 70% +/- 12% (mean +/- standard deviation) at admission and 71% +/- 10% six hours later (p = 0.484). Overall 28-day mortality was 18%, LOSICU was 3 (1 to 28) days, and LOShospital was 19 (1 to 28) days. Patients with an ScvO2 of less than 60% at admission had higher mortality than patients with an ScvO2 of more than 60% (29% versus 17%, p < 0.05). Changes in ScvO2 during the first six hours were not predictive of LOSICU, LOShospital, or mortality.


CONCLUSIONS
Low ScvO2 in unplanned admissions and high SAPS II are associated with increased mortality. Standard ICU treatment increased ScvO2 in patients with a low admission ScvO2, but the increase was not associated with LOSICU or LOShospital.
Bracht
Hendrik
H
Department of Intensive Care Medicine, University Hospital Bern, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland. hendrik.bracht@uniklinik-ulm.de
Hänggi
Matthias
M
Jeker
Barbara
B
Wegmüller
Ninja
N
Porta
Francesca
F
Tüller
David
D
Takala
Jukka
J
Jakob
Stephan M
SM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous; D003422:Critical Care; D016638:Critical Illness / Q000145:classification / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008875:Middle Aged; D019370:Observation; D010100:Oxygen / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D012720:Severity of Illness Index
D010100:Oxygen