title: The role of central venous oxygen saturation, blood lactate, and central venous-to-arterial carbon dioxide partial pressure difference as a goal and prognosis of sepsis treatment.
abstract: The current practice in treatment of severe sepsis and septic shock is to ensure adequate oxygenation and perfusion in patients, along with prompt administration of antibiotics, within 6 hours from diagnosis, which is considered the "golden hour" for the patients. One of the goals of treatment is to restore normal tissue perfusion. With this goal in mind, some parameters have been used to determine the success of treatment and mortality rate; however, none has been proven to be the best predictor of mortality rate in sepsis patients. Despite growing evidence regarding the prognostic indicators for mortality in sepsis patients, inconsistent reports exist.
  
  
  
  This review comprehensively summarizes the reports regarding the frequently used parameters in sepsis including central venous oxygen saturation, blood lactate, and central venous-to-arterial carbon dioxide partial pressure difference, as prognostic indicators for clinical outcomes in sepsis patients. Moreover, consistent findings and inconsistent reports for their pathophysiology and the potential mechanisms for their use as well as their limitations in sepsis patients are presented and discussed. Finally, a schematic strategy for potential management and benefits in sepsis patients is proposed based upon these current available data.
  
  
  
  There is currently no ideal biomarker that can indicate prognosis, predict progression of the disease, and guide treatment in sepsis. Further studies are needed to be carried out to identify the ideal biomarker that has all the desired properties.
authors: Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors: Borwon
authors: B
authors: Wittayachamnankul
authors: Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors: Boriboon
authors: B
authors: Chentanakij
authors: Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors: Kamphee
authors: K
authors: Sruamsiri
authors: Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. Electronic address: nchattip@gmail.com.
authors: Nipon
authors: N
authors: Chattipakorn
mesh_terms: D002245:Carbon Dioxide / Q000097:blood*; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D010100:Oxygen / Q000097:blood*; D010313:Partial Pressure; D010347:Patient Care Planning; D011379:Prognosis; D011446:Prospective Studies; D012151:Resuscitation; D018805:Sepsis / Q000097:blood / Q000401:mortality / Q000628:therapy; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality / Q000628:therapy
chemical_list: D002245:Carbon Dioxide; D019344:Lactic Acid; D010100:Oxygen
keywords: Central venous oxygen saturation; Central venous-to-arterial carbon dioxide partial pressure difference; Lactate; Lactate clearance; Septic shock; Severe sepsis