POSTER PRESENTATION 2: Critical Care/Experimental Medicine : PS2-40 ; The 6-hr Central Venous Oxygen Saturation Goal Has No Prognostic Value in Septic Shock Patients = POSTER PRESENTATION 2: Critical Care/Experimental Medicine : PS2-40 ; The 6-hr Central Venous Oxygen Saturation Goal Has No Prognostic Value in Septic Shock Patients

다국어 초록 (Multilingual Abstract)

Central venous oxygen saturation (ScvO2) is used as an indicator of adequate tissue oxygenation and current sepsis guideline includes ScvO2 70% or more as one of four initial resuscitation goals during the first 6 hrs. However, it is still controversial that to achieve ScvO2 goal is mandatory. The objective of this study was to investigate the prognostic value of 6-hr ScvO2 to predict the 1-month survival in patients with septic shock. We have retrospectively analyzed 305 patients with septic shock treated in a single academic emergency ICU. All patients were treated using goal-directed protocol. Demographics, predisposing factors, site of infection and admission APACHE II score were abstracted. Hemodynamic (mean arterial pressure [MAP]; central venous pressure) and laboratory (ScvO2, lactic acid) parameters at baseline and 6-hr were recorded. To test the prognostic value of 6-hr ScvO2, area under the receiver operating characteristics curve (AUROC) to predict 1-month survival was calculated and compared with that of 6-hr lactic acid. Also, the correlation between 6-hr ScvO2 or lactic acid and admission APACHE II was tested. Subgroup analysis was performed according to the achievement of 6-hr MAP. Among 305 patients enrolled, 92 (30.2%) died in 1-month. AUROC of 6-hr ScvO2 to predict 1-month survival was 0.558 (95% confidence interval, 0.485-0.631). AUROC of 6-hr lactic acid to predict 1-month mortality was 0.760 (0.698-0.822). In patients who achieved 6-hr MAP (n=275), AUROC of 6-hr ScvO2 was 0.520 (0.441-0.598). However, in patients who did not achieve 6-hr MAP (n=30), AUROC of 6-hr ScvO2 was 0.763 (0.591-0.936). 6-hr ScvO2 did not have any association with APACHE II (coefficient=-0.056, p=0.327). However, the 6-hr lactic acid moderately correlated with APACHE II (coefficient=0.573, p<0.001). The 6-hr ScvO2 has no prognostic value in patients with septic shock. However, this finding was not observed in patients who did not achieve 6-hr target MAP.