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Comment
. 2008;12(2):130.
doi: 10.1186/cc6841. Epub 2008 Apr 7.

The pursuit of a high central venous oxygen saturation in sepsis: growing concerns

Affiliations
Comment

The pursuit of a high central venous oxygen saturation in sepsis: growing concerns

Rinaldo Bellomo et al. Crit Care. 2008.

Abstract

In this issue of Critical Care, Dutch investigators report that, in a cohort of patients with sepsis/septic shock admitted to three different intensive care units (ICUs), low central venous oxygen saturation (ScvO2) was uncommon at the time of ICU admission, and hospital mortality was <30%. Their findings, taken together with those of recent reports from Australia and New Zealand (ANZ), raise serious concerns about the utility of early goal directed therapy (EGDT) outside the context of the original trial. Despite inclusion of EGDT into the Surviving Sepsis Guidelines, in response to growing uncertainty, ANZ and US investigators will soon begin randomization of patients into two large multicentre trials comparing EGDT to standard therapy. Until such studies are completed, basing international treatment guidelines on a single centre study performed in what may turn out to be a highly atypical environment would seem premature.

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References

    1. van Beest PA, Hofstra JJ, Schultz MJ, Boerma EC, Spronk PE, Kuiper MA. The incidence of low venous oxygen saturation on admission to the intensive care unit: a multi-centre observational study in The Netherlands. Crit Care. 2008;12:R33. doi: 10.1186/cc6811. - DOI - PMC - PubMed
    1. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Tomlanovich M. Early goal directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368–1377. doi: 10.1056/NEJMoa010307. - DOI - PubMed
    1. Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med. 2008;34:17–60. doi: 10.1007/s00134-007-0934-2. - DOI - PMC - PubMed
    1. Ho BCH, Bellomo R, McGain F, Jones D, Naka T, Wan L, Bratiberg G. The incidence and outcome of septic shock patients in the absence of early goal directed therapy. Crit Care. 2006;10:R80. doi: 10.1186/cc4918. - DOI - PMC - PubMed
    1. The ARISE Investigators and the ANZICS Adult Patient Database Management Committee The outcome of patients with sepsis and septic shock presenting to emergency departments in Australia and New Zealand. Crit Care Resusc. 2007;9:8–18. - PubMed

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