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Mixed venous oxygen saturation as an index of goal-directed therapy in postoperative care after cardiac surgery.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0003-4173-8565
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
2015 (English)Conference paper, Poster (Other academic)
Abstract [en]

Background: Adequate mixed venous oxygen saturation (SvO2) indicates sufficient oxygen supply and better prognosis after cardiac surgery.

Aim: In this study, clinical significance of SvO2 as an index of goal-directed therapy in postope-rative care after cardiac surgery was retrospectively assessed.

Methods: SvO2 was collected postoperatively from 741 consecutive adult patients under-going different types of cardiac surgery. SvO2 on admission to ICU was defined as base point (SvO2base). SvO2 was followed every 6 hours or whenever necessary to evaluate efficacy of postoperative therapy in the first 24 hours. Receiver operating characteristic (ROC) analysis was used to analyze changes of SvO2 (△SvO2) in relation to hospital mortality.

Results: SvO2base demonstrated significant discriminatory power with regard to hospital mortality ( AUC 0.70; 95% CI 0.57-0.81; P=0.000). The best cutoff for SvO2base was 56.8%. Average △SvO2A for patients with SvO2base ≤56.8% (Group A ) was 10.6%. The best cutoff for △SvO2A with regard to hospital mortality was 6.6%, with a sensitivity of 0.68 and speci-ficity of 0.72. The negative predictive value was 91.2%. Average △SvO2B for patients with SvO2base>56.8% (Group B) was -2.4%. The best cutoff for △SvO2B with regard to hospital mortality was -4.5%, with a sensitivity of 0.61 and specificity of 0.79.The negative predictive value was 99.5%.

Conclusion: An increase of SvO2 by more than 6.6% in patients with SvO2base≤56.8% may improve prognosis significantly. Goal of ICU therapy for patients with SvO2base> 56.8% should be to avoid a drop of SvO2 by more than 4.5%, in order to prevent from worsened prognosis.

Place, publisher, year, edition, pages
2015. 79-79 p.
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-124326OAI: oai:DiVA.org:liu-124326DiVA: diva2:897849
Conference
7th joint Scandinavian Conference in Cardiothoracic Surgery,Bergen, Norway, 3-5 September 2015
Available from: 2016-01-26 Created: 2016-01-26 Last updated: 2016-02-08Bibliographically approved

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Jiang, HuiqiSvedjeholm, RolfYang, Yanqi
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Thoracic and Vascular Surgery
Cardiac and Cardiovascular Systems

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