caa a22 4500 605510148 CHVBK 20210128100644.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s10877-015-9683-x doi (NATIONALLICENCE)springer-10.1007/s10877-015-9683-x Prospective evaluation of regional oxygen saturation to estimate central venous saturation in sepsis [Elektronische Daten] [Christian Koch, Rainer Röhrig, Tobias Monz, Andreas Hecker, Florian Uhle, Emanuel Schneck, Markus Weigand, Christoph Lichtenstern] Current treatment guidelines for sepsis claim an early goal-directed hemodynamic optimization including fluid resuscitation, use of vasopressors and inotropic agents. We investigated the correlation between the prominent treatment goal central venous saturation (ScvO2) and the frontal and the thenar regional oxygen saturation (rSO2) measured by near infrared spectroscopy. Secondary, we examined the value of ScvO2, lactate levels and rSO2 as surrogate markers of an impaired tissue oxygenation for outcome prediction in sepsis. This prospective, observational study was performed at the surgical intensive care unit of the University Hospital Giessen. A total of 50 patients with sepsis, severe sepsis or septic shock were included. ScvO2, rSO2 and lactate were measured at sepsis diagnosis (baseline), 24 and 48h, thereafter. We investigated the predictive value of frontal and thenar rSO2 for a decreased SvcO2 under 70%. For survivor and non-survivors ScvO2, rSO2 and lactate were analysed. Patients with ScvO2 >70% showed a trend to higher levels of fontal rSO2 (62.81±8.06 vs. 53.54±15.48; p=0.058). ROC-analysis revealed a minor prediction of a decreased ScvO2 by frontal rSO2 levels at baseline (AUC=0.687; 95% CI 0.511-0.863; p=0.047). Combined measurements of lactate and ScvO2 showed significantly elevated mortality for patients with ScvO2 ≥70% and lactate levels ≥2.5mmol/l (log rank test p=0.004). In the group with ScvO2 <70% and lactate levels <2.5mmol/l no patients died during the observation period. Frontal rSO2 correlates with ScvO2 but both frontal and thenar rSO2 do not exactly discriminate between patients with high or low ScvO2 in sepsis. The combination of elevated lactate >2.5mmol/l and ScvO2 >70% is highly associated with poor outcome in ICU patients with sepsis, severe sepsis and septic shock. Springer Science+Business Media New York, 2015 Sepsis nationallicence Spectroscopy nationallicence Near infrared nationallicence Lactic acid nationallicence Central venous saturation nationallicence Oxygen consumption nationallicence Outcome assessment nationallicence Koch Christian Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut Röhrig Rainer Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut Monz Tobias Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut Hecker Andreas Department of General and Thoracic Surgery, University Hospital of Giessen and Marburg, 35392, Giessen, Germany aut Uhle Florian Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut Schneck Emanuel Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut Weigand Markus Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut Lichtenstern Christoph Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut Journal of Clinical Monitoring and Computing Springer Netherlands 29/4(2015-08-01), 443-453 1387-1307 29:4<443 2015 29 10877 https://doi.org/10.1007/s10877-015-9683-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-015-9683-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Koch Christian Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut NATIONALLICENCE 700 1- Röhrig Rainer Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut NATIONALLICENCE 700 1- Monz Tobias Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut NATIONALLICENCE 700 1- Hecker Andreas Department of General and Thoracic Surgery, University Hospital of Giessen and Marburg, 35392, Giessen, Germany aut NATIONALLICENCE 700 1- Uhle Florian Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut NATIONALLICENCE 700 1- Schneck Emanuel Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut NATIONALLICENCE 700 1- Weigand Markus Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut NATIONALLICENCE 700 1- Lichtenstern Christoph Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/4(2015-08-01), 443-453 1387-1307 29:4<443 2015 29 10877