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Multicentre study on peri- and postoperative central venous oxygen saturation in high-risk surgical patients.
Crit Care. 2006; 10(6):R158.CC

Abstract

INTRODUCTION

Low central venous oxygen saturation (ScvO2) has been associated with increased risk of postoperative complications in high-risk surgery. Whether this association is centre-specific or more generalisable is not known. The aim of this study was to assess the association between peri- and postoperative ScvO2 and outcome in high-risk surgical patients in a multicentre setting.

METHODS

Three large European university hospitals (two in Finland, one in Switzerland) participated. In 60 patients with intra-abdominal surgery lasting more than 90 minutes, the presence of at least two of Shoemaker's criteria, and ASA (American Society of Anesthesiologists) class greater than 2, ScvO2 was determined preoperatively and at two hour intervals during the operation until 12 hours postoperatively. Hospital length of stay (LOS) mortality, and predefined postoperative complications were recorded.

RESULTS

The age of the patients was 72 +/- 10 years (mean +/- standard deviation), and simplified acute physiology score (SAPS II) was 32 +/- 12. Hospital LOS was 10.5 (8 to 14) days, and 28-day hospital mortality was 10.0%. Preoperative ScvO2 decreased from 77% +/- 10% to 70% +/- 11% (p < 0.001) immediately after surgery and remained unchanged 12 hours later. A total of 67 postoperative complications were recorded in 32 patients. After multivariate analysis, mean ScvO2 value (odds ratio [OR] 1.23 [95% confidence interval (CI) 1.01 to 1.50], p = 0.037), hospital LOS (OR 0.75 [95% CI 0.59 to 0.94], p = 0.012), and SAPS II (OR 0.90 [95% CI 0.82 to 0.99], p = 0.029) were independently associated with postoperative complications. The optimal value of mean ScvO2 to discriminate between patients who did or did not develop complications was 73% (sensitivity 72%, specificity 61%).

CONCLUSION

Low ScvO2 perioperatively is related to increased risk of postoperative complications in high-risk surgery. This warrants trials with goal-directed therapy using ScvO2 as a target in high-risk surgery patients.

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17101038

Citation

Collaborative Study Group on Perioperative ScvO2 Monitoring. "Multicentre Study On Peri- and Postoperative Central Venous Oxygen Saturation in High-risk Surgical Patients." Critical Care (London, England), vol. 10, no. 6, 2006, pp. R158.
Collaborative Study Group on Perioperative ScvO2 Monitoring. Multicentre study on peri- and postoperative central venous oxygen saturation in high-risk surgical patients. Crit Care. 2006;10(6):R158.
Collaborative Study Group on Perioperative ScvO2 Monitoring. (2006). Multicentre study on peri- and postoperative central venous oxygen saturation in high-risk surgical patients. Critical Care (London, England), 10(6), R158.
Collaborative Study Group on Perioperative ScvO2 Monitoring. Multicentre Study On Peri- and Postoperative Central Venous Oxygen Saturation in High-risk Surgical Patients. Crit Care. 2006;10(6):R158. PubMed PMID: 17101038.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multicentre study on peri- and postoperative central venous oxygen saturation in high-risk surgical patients. A1 - ,, PY - 2006/07/05/received PY - 2006/08/30/revised PY - 2006/11/13/accepted PY - 2006/11/15/pubmed PY - 2007/3/27/medline PY - 2006/11/15/entrez SP - R158 EP - R158 JF - Critical care (London, England) JO - Crit Care VL - 10 IS - 6 N2 - INTRODUCTION: Low central venous oxygen saturation (ScvO2) has been associated with increased risk of postoperative complications in high-risk surgery. Whether this association is centre-specific or more generalisable is not known. The aim of this study was to assess the association between peri- and postoperative ScvO2 and outcome in high-risk surgical patients in a multicentre setting. METHODS: Three large European university hospitals (two in Finland, one in Switzerland) participated. In 60 patients with intra-abdominal surgery lasting more than 90 minutes, the presence of at least two of Shoemaker's criteria, and ASA (American Society of Anesthesiologists) class greater than 2, ScvO2 was determined preoperatively and at two hour intervals during the operation until 12 hours postoperatively. Hospital length of stay (LOS) mortality, and predefined postoperative complications were recorded. RESULTS: The age of the patients was 72 +/- 10 years (mean +/- standard deviation), and simplified acute physiology score (SAPS II) was 32 +/- 12. Hospital LOS was 10.5 (8 to 14) days, and 28-day hospital mortality was 10.0%. Preoperative ScvO2 decreased from 77% +/- 10% to 70% +/- 11% (p < 0.001) immediately after surgery and remained unchanged 12 hours later. A total of 67 postoperative complications were recorded in 32 patients. After multivariate analysis, mean ScvO2 value (odds ratio [OR] 1.23 [95% confidence interval (CI) 1.01 to 1.50], p = 0.037), hospital LOS (OR 0.75 [95% CI 0.59 to 0.94], p = 0.012), and SAPS II (OR 0.90 [95% CI 0.82 to 0.99], p = 0.029) were independently associated with postoperative complications. The optimal value of mean ScvO2 to discriminate between patients who did or did not develop complications was 73% (sensitivity 72%, specificity 61%). CONCLUSION: Low ScvO2 perioperatively is related to increased risk of postoperative complications in high-risk surgery. This warrants trials with goal-directed therapy using ScvO2 as a target in high-risk surgery patients. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/17101038/Multicentre_study_on_peri__and_postoperative_central_venous_oxygen_saturation_in_high_risk_surgical_patients_ L2 - https://ccforum.biomedcentral.com/articles/10.1186/cc5094 DB - PRIME DP - Unbound Medicine ER -