title: High central venous oxygen saturation in the latter stages of septic shock is associated with increased mortality.
abstract: BACKGROUND
  Current guidelines recommend maintaining central venous oxygen saturation (ScvO2) higher than 70% in patients with severe sepsis and septic shock. As high levels of ScvO2 may reflect an inadequate use of oxygen, our aim was to evaluate the relation between maximal ScvO2 levels (ScvO2max) and survival among intensive care unit (ICU) patients with septic shock.
  
  
  METHODS
  We retrospectively analyzed data from all admissions to our ICU between January 2008 and December 2009. All septic shock patients in whom the ScvO2 was measured were included. The measures of ScvO2max within the first 72 hours after the onset of shock were collected.
  
  
  RESULTS
  A total of 1,976 patients were screened and 152 (7.7%) patients met the inclusion criteria. The level of ScvO2max was 85% (78 to 89) in the non-survivors, compared with 79% (72 to 87) in the survivors (P = 0.009).
  
  
  CONCLUSIONS
  Our findings raise concerns about high levels of ScvO2 in patients with septic shock. This may reflect the severity of the shock with an impaired oxygen use. Future strategies may target an optimization of tissue perfusion in this specific subgroup of patients.
authors.affiliation: Service d'anesthésie et de réanimation, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Université de la Méditerranée, Chemin des bourrely, 13915 Marseille Cedex 20, France. julien.textoris@gmail.com
authors.forename: Julien
authors.initials: J
authors.lastname: Textoris
authors.forename: Louis
authors.initials: L
authors.lastname: Fouché
authors.forename: Sandrine
authors.initials: S
authors.lastname: Wiramus
authors.forename: François
authors.initials: F
authors.lastname: Antonini
authors.forename: Sowita
authors.initials: S
authors.lastname: Tho
authors.forename: Claude
authors.initials: C
authors.lastname: Martin
authors.forename: Marc
authors.initials: M
authors.lastname: Leone
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous; D005260:Female; D005602:France; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D012189:Retrospective Studies; D012772:Shock, Septic / Q000401:mortality* / Q000503:physiopathology*; D016019:Survival Analysis
chemical_list: D010100:Oxygen