title: 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.
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.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Huh
authors.forename: Bum Jin
authors.initials: BJ
authors.lastname: Oh
authors.forename: Chae-Man
authors.initials: CM
authors.lastname: Lim
authors.forename: Sang-Bum
authors.initials: SB
authors.lastname: Hong
authors.forename: Younsuck
authors.initials: Y
authors.lastname: Koh
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D017063:Outcome Assessment, Health Care; D010100:Oxygen / Q000097:blood*; D010865:Pilot Projects; D011446:Prospective Studies; D012151:Resuscitation / Q000379:methods; D018805:Sepsis / Q000097:blood* / Q000401:mortality; D012772:Shock, Septic / Q000097:blood
chemical_list: D010100:Oxygen
keywords: infectious diseases; respiratory, pneumonia/infections; resuscitation, clinical care