Sunday April 23, 2006
Hemodynamic variables to watch in septic shock
Dr Varpula and coll. from Helsinki, Finland tried to identify the most related hemodynamic variables in 111 septic shock patients. Data from 6 hours and 48 hours were analyzed separately. Primary endpoint was 30-day mortality. Following results were found:
1. Univariate analysis showed that lactate level on arrival and MAP-derived variables (average of all MAP values, hypotension time) during the first 6 hours correlated with the 30-day mortality.
2. The best cutoff values for hypotension and hypoperfusion times were found to be MAP of 65 mmHg and SvO2 of 70%, respectively.
In conclusion, data suggest that time spent with low BP and with inadequate CO (decrease SvO2) are the most important hemodynamic variables related to outcome. This study find threshold values in synchrony with values published in recent guidelines.
Related Sites: survivingsepsis.org
Related Previous pearls: Shock alert , ScvO2 or SvO2 ? and EGDT and PAC need
References:
1.Hemodynamic variables related to outcome in septic shock - Intensive Care Medicine, Volume 31, Number 8 , August 2005, Pages: 1066 - 1071
