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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Should we use central venous saturation to guide management in high-risk surgical patients? | Available online http ccforum.eom content 10 6 181 Commentary Should we use central venous saturation to guide management in high-risk surgical patients Rupert M Pearse and Charles J Hinds Barts and The London School of Medicine and Dentistry Queen Mary s University of London 5th floor 38 Little Britain St. Bartholomew s Hospital London EC1A 7BE UK Corresponding author Rupert Pearse rupert.pearse@bartsandthelondon.nhs.uk Published 15 December 2006 Critical Care 2006 10 181 doi 10.1186 cc5122 This article is online at http ccforum.com content 10 6 181 2006 BioMed Central Ltd See related research by The Collaborative Study Group on Perioperative ScvO2 Monitoring http ccforum.com content 10 6 R158 Abstract Measurements of central venous oxygen saturation ScvO2 have been successfully used to guide haemodynamic therapy in critical care. The efficacy of this approach in the treatment of severe sepsis and septic shock has stimulated interest in the use of ScvO2 to guide management in patients undergoing major surgery. The physiological basis of ScvO2 measurement is complex. A number of outstanding issues will need to be resolved before incorporating ScvO2 measurement into routine practice. First it is not yet clear which value of ScvO2 should be targeted. Second there is some uncertainty as to which interventions are the most effective for achieving the desired value of ScvO2 or how long this value should be maintained. The study by The Collaborative Study Group on Perioperative ScvO2 Monitoring published in this edition of Critical Care may help provide answers to some of these questions. Our understanding of ScvO2 measurement remains limited however and the routine use of peri-operative ScvO2-guided goal-directed therapy cannot be recommended until a large randomised trial has confirmed the value of this approach. The use of central venous saturation ScvO2 to guide haemodynamic management is an important and evolving aspect of clinical practice. An observational study 1
