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Assessing Global Perfusion During Sepsis: SvO2, Venoarterial PCO2 Gap or Both?

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Annual Update in Intensive Care and Emergency Medicine 2015

Part of the book series: Annual Update in Intensive Care and Emergency Medicine 2015 ((AUICEM,volume 2015))

Abstract

Systemic blood flow can be measured easily at the bedside in critically ill patients. However, measuring cardiac output cannot tell much about the adequacy of systemic blood flow for global metabolic conditions. For example, a cardiac output of 5 l/min, which is normal in a healthy human at rest, is abnormally low during exercise or under other conditions of marked increase in oxygen (O2) demand, such as sepsis. Therefore, the simple measurement of cardiac output cannot provide sufficient information about the need to increase systemic blood flow. The mixed venous blood O2 saturation (SvO2) and the difference between mixed venous and arterial blood carbon dioxide (CO2) pressures (PCO2 gap) have been proposed to assess the adequacy of cardiac output to metabolic conditions and thus to serve to evaluate the need to increase cardiac output. Since central venous catheters are now more often inserted than pulmonary artery catheters (PACs) in critically ill patients, O2 saturation measured in a central vein (ScvO2) and the difference between CO2 pressure in a central vein and arterial CO2 pressure have been proposed as substitutes for SvO2 and PCO2 gap, respectively.

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Authors and Affiliations

  1. Service de réanimation médicale, Hôpital de Bicêtre, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France

    J.-L. Teboul & X. Monnet

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  1. J.-L. Teboul
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  2. X. Monnet
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Correspondence to J.-L. Teboul .

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  1. Université libre de Bruxelles, Dept. of Intensive Care, Erasme Hospital, Brussels, Belgium

    Jean-Louis Vincent Prof.

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Teboul, JL., Monnet, X. (2015). Assessing Global Perfusion During Sepsis: SvO2, Venoarterial PCO2 Gap or Both?. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2015. Annual Update in Intensive Care and Emergency Medicine 2015, vol 2015. Springer, Cham. https://doi.org/10.1007/978-3-319-13761-2_19

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  • DOI: https://doi.org/10.1007/978-3-319-13761-2_19

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-13760-5

  • Online ISBN: 978-3-319-13761-2

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