Changes of central venous oxygen saturation define fluid responsiveness in patients with septic shock: A prospective observational study.
To evaluate whether the changes of central venous oxygen saturation (Scvo2) after fluid challenge can define fluid responsiveness in patients with septic shock.



In this prospective observational study, septic shock patients with invasive cardiac output monitoring requiring fluid challenge were included. Cardiac index (CI) and Scvo2were measured before and after fluid challenges. The changes of CI (ΔCI) and the changes of Scvo2(ΔScvo2) were calculated and analyzed using Pearson correlation. Receiver operating characteristics curve (ROC) analysis was used to classify fluid responders and nonresponders. Area under ROC was calculated.



Forty patients were included and 18 patients (45%) were fluid responders. In the responders, CI increased from 3.4±1.1 to 4.4±1.0 L min-1m-2and Scvo2from 69.6%±9.8% to 77.1%±8.9% (both P<.001) after fluid challenge. In the nonresponders, neither CI nor Scvo2changed (4.1±1.3 vs 4.1±1.3 L min-1m-2, 71.0%±13.8% vs 70.6%±14.1%, both P>.05). The correlation between ΔScvo2and ΔCI was significant (r=0.702, P<.001). The area under ROC of ΔScvo2to define fluid responsiveness was 0.88 (95% confidence interval [95% CI], 0.76-0.99). A ΔScvo2threshold value of 5.0% discriminated responders from nonresponders with sensitivity of 0.78 (95% CI, 0.52-0.93) and specificity of 0.95 (95% CI, 0.75-1.00).



The changes of Scvo2correlate with the changes of CI, and the changes of Scvo2define fluid responsiveness in patients with septic shock.
Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, PR China. Electronic address: xubiao0302@163.com.
Biao
B
Xu
Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, PR China. Electronic address: want.tofly@aliyun.com.
Xiaobo
X
Yang
Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, PR China. Electronic address: wangchunyao@pumch.cn.
Chunyao
C
Wang
Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, PR China. Electronic address: edwardjw@163.com.
Wei
W
Jiang
Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, PR China. Electronic address: wengli@pumch.cn.
Li
L
Weng
Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, PR China. Electronic address: emi75@sina.com.
Xiaoyun
X
Hu
Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, PR China. Electronic address: pjm731@hotmail.com.
Jinmin
J
Peng
Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, PR China. Electronic address: dubin98@gmail.com.
Bin
B
Du
D002405:Catheterization, Central Venous; D003422:Critical Care; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012772:Shock, Septic / Q000628:therapy*
D010100:Oxygen
Central venous oxygen saturation; Fluid responsiveness; Septic shock