RELATIONSHIP BETWEEN CENTRAL AND PERIPHERAL VENOUS OXYGEN SATURATION AND LACTATE LEVELS: A PROSPECTIVE STUDY
RELATIONSHIP BETWEEN CENTRAL AND PERIPHERAL VENOUS OXYGEN SATURATION AND LACTATE LEVELS: A PROSPECTIVE STUDY
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DOI：
10.1016/j.jemermed.2016.03.021
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发表时间：
2016-06-01
影响因子：
1.5
通讯作者：
Rivers, Emanuel P.
中科院分区：
文献类型：
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作者：
Goyal, Nikhil;Taylor, Andrew R.;Rivers, Emanuel P.
背景：优化组织氧输送以满足消耗需求在危重患者复苏中非常重要。中心静脉血氧饱和度（ScvO（2））和乳酸水平通常用于指导复苏;然而，前者需要有创监测。寻找微创替代方法的临床医生可以考虑使用外周静脉血氧饱和度（SpvO（2））和乳酸水平作为替代。目的：确定SpvO（2）和ScvO（2）与外周和中枢乳酸水平的关系。方法：所有在学术急诊科和重症监护室使用中心静脉导管的患者都有资格参加本研究。从中心静脉和外周静脉同时获得血液，并测量氧饱和度和乳酸水平。使用组内相关系数（ICC）、Bland-Altman图和受试者工作特征曲线对结果进行分析。结果：共分析了79例配对血标本。SpvO（2）和ScvO（2）具有中度一致性：ICC = 0.53（95%置信区间[CI] 0.35-0.67）。Bland-Altman图显示了显著偏倚（-4.47;一致性限-38.6，29.6）。SpvO（2）>= 85%对ScvO（2）>= 70%具有90%的特异性，
Background: Optimization of tissue oxygen delivery to meet consumption demands is important in the resuscitation of critically ill patients. Central venous oxygen saturation (ScvO(2)) and lactate levels are often used to guide resuscitation; however, invasive monitoring is required for the former. Clinicians searching for less invasive alternatives may consider using peripheral venous oxygen saturation (SpvO(2)) and lactate levels as a substitute. Objectives: To determine the relationship between SpvO(2) and ScvO(2) and peripheral and central lactate levels. Methods: All patients with a central venous catheter in an academic emergency department and intensive care unit were eligible for the study. Blood was obtained simultaneously from a central and peripheral vein and measured for oxygen saturation and lactate levels. Results were analyzed using intraclass correlation coefficient (ICC), Bland-Altman plots, and receiver operating characteristic curves. Results: Seventynine paired blood samples were analyzed. SpvO(2) and ScvO(2) have moderate agreement: ICC = 0.53 (95% confidence interval [CI] 0.35-0.67). A Bland-Altman plot revealed substantial bias (-4.47; limits of agreement -38.6, 29.6). SpvO(2) >= 85% was 90% specific for ScvO(2) >= 70%, and SpvO(2) of