Research

Incidence of low central venous oxygen saturation during unplanned admissions in a multidisciplinary intensive care unit: an observational study

Hendrik Bracht , Matthias Hänggi , Barbara Jeker , Ninja Wegmüller , Francesca Porta , David Tüller , Jukka Takala and Stephan M Jakob

Department of Intensive Care Medicine, University Hospital Bern, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland

author email corresponding author email

Critical Care 2007, 11:R2doi:10.1186/cc5144

Published:	9 January 2007

Abstract

Introduction

It has been shown that early central venous oxygen saturation (ScvO₂)-guided optimization of hemodynamics can improve outcome in septic patients. The early ScvO₂ profile of other patient groups is unknown. The aim of this study was to characterize unplanned admissions in a multidisciplinary intensive care unit (ICU) with respect to ScvO₂ and outcome.

Methods

Ninety-eight consecutive unplanned admissions to a multidisciplinary ICU (median age 63 [range 19 to 83] years, median Simplified Acute Physiology Score [SAPS II] 43 [range 11 to 92]) with a clinical indication for a central venous catheter were included in the study. ScvO₂ was assessed at ICU arrival and six hours later but was not used to guide treatment. Length of stay in ICU (LOS_ICU) and in hospital (LOS_hospital) and 28-day mortality were recorded.

Results

ScvO₂ was 70% ± 12% (mean ± standard deviation) at admission and 71% ± 10% six hours later (p = 0.484). Overall 28-day mortality was 18%, LOS_ICU was 3 (1 to 28) days, and LOS_hospital was 19 (1 to 28) days. Patients with an ScvO₂ of less than 60% at admission had higher mortality than patients with an ScvO₂ of more than 60% (29% versus 17%, p < 0.05). Changes in ScvO₂ during the first six hours were not predictive of LOS_ICU, LOS_hospital, or mortality.

Conclusion

Low ScvO₂ in unplanned admissions and high SAPS II are associated with increased mortality. Standard ICU treatment increased ScvO₂ in patients with a low admission ScvO₂, but the increase was not associated with LOS_ICU or LOS_hospital.