Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Central venous O2 saturation and venous-toarterial CO2 difference as complementary tools for goal-directed therapy during high-risk surgery. | Futier et al. Critical Care 2010 14 R193 http content 14 5 R193 c CRITICAL CARE RESEARCH Open Access Central venous O2 saturation and venous-to-arterial CO2 difference as complementary tools for goal-directed therapy during high-risk surgery 1 2 1 11 1 Emmanuel Futier Emmanuel Robin Matthieu Jabaudon Renaud Guerin Antoine Petit Jean-Etienne Bazin Jean-Michel Constantin1 Benoit Vallet2 Abstract Introduction Central venous oxygen saturation ScvO2 is a useful therapeutic target in septic shock and high-risk surgery. We tested the hypothesis that central venous-to-arterial carbon dioxide difference P cv-a CO2 a global index of tissue perfusion could be used as a complementary tool to ScvO2 for goal-directed fluid therapy GDT to identify persistent low flow after optimization of preload has been achieved by fluid loading during high-risk surgery. Methods This is a secondary analysis of results obtained in a study involving 70 adult patients ASA I to III undergoing major abdominal surgery and treated with an individualized goal-directed fluid replacement therapy. All patients were managed to maintain a respiratory variation in peak aortic flow velocity below 13 . Cardiac index CI oxygen delivery index DO2i ScvO2 P cv-a CO2 and postoperative complications were recorded blindly for all patients. Results A total of 34 of patients developed postoperative complications. At baseline there was no difference in demographic or haemodynamic variables between patients who developed complications and those who did not. In patients with complications during surgery both mean ScvO2 78 4 versus 81 4 P and minimal ScvO2 minScvO2 67 6 versus 72 6 P were lower than in patients without complications despite perfusion of similar volumes of fluids and comparable CI and DO2i values. The optimal ScvO2 cut-off value was and minScvO2 70 was independently associated with the development of postoperative complications OR 95 CI to P . P cv-a CO2 was
