Author/Editor		Kremžar, B; Špec-Marn, A; Kompan, L; Cerović, O
Title		Normal values of SvO2 as therapeutic goal in patients with multiple injuries
Type		članek
Source		Intensive Care Med
Vol. and No.		Letnik 23, št. 1
Publication year		1997
Volume		str. 65-70
Language		eng
Abstract		OBJECTIVE: To determine whether maintaining normal levels of mixed venous oxygen saturation (SvO2) in patients with multiple injuries is more relevant to survival than maintaining above-normal levels of oxygen transport. DESIGN: Non-randomised, retrospective control study over a 38-month period. SETTING: Multidisciplinary intensive care unit in a university hospital. PATIENTS: 40 patients with multiple injuries divided in to group A (23 patients) and group B (17 patients). INTERVENTIONS: In group A patients, we maintained normal SvO2 by manipulation of oxygen transport variables: oxygen delivery (DO2) was increased only if SvO2 decreased or the dobutamine test was positive. In group B patients, DO2 was routinely maintained at above-normal levels by aggressive use of fluids and dobutamine. MEASUREMENTS AND RESULTS: In group A we measured SvO2 continuously and performed the dobutamine test. Oxygen transport-related variables were recorded every 12 h in the first 5 days after injury in both groups, as well as lactate concentrations. Survival was significantly greater in group A than in group B (p < 0.01). Multiple organ failure was less frequent in group A than in group B (p < 0.01). The average DO2 in group A was significantly lower than in group B from day 2 onwards (p < 0.05-0.01). Average values of DO2 of 605-688 ml/ min per m2 were required to maintain normal SvO2 and aerobic metabolism in group A; 10 patients required dobutamine 2.5-5 micrograms/kg per min. The average DO2 in group B was 622 ml/ min per m2 on day 1 and then it increased to 835 ml/min per m2 on day 5 after trauma. CONCLUSIONS: Our results indicate that for patients with multiple injuries maintaining normal SvO2 values and increasing DO2 only if required are more relevant for survival than routine maintenance of above-normal oxygen transport values.
Descriptors		INJURY SEVERITY SCORE INTENSIVE CARE UNITS MULTIPLE ORGAN FAILURE MULTIPLE TRAUMA OXYGEN ADULT ANALYSIS OF VARIANCE CHI-SQUARE DISTRIBUTION RESPIRATION, ARTIFICIAL RETROSPECTIVE STUDIES STATISTICS, NONPARAMETRIC SURVIVAL RATE