Prognostic value of central venous oxygen saturation and blood lactate levels measured simultaneously in the same patients with severe systemic inflammatory response syndrome

학위논문 (석사)-- 서울대학교 대학원 : 임상의과학과, 2014. 2. 이상민.Introduction: Blood lactate levels and central venous oxygen saturation(ScvO2) are known to be useful indicators of global tissue hypoxia. However, it is unclear whether ScvO2 correlates with lactate levels when measured simultaneously and whether changes in ScvO2 or lactate levels in serial measurements have prognostic value. We investigated the correlation between ScvO2 and lactate levels measured simultaneously and their association with clinical outcomes Methods: We performed a prospective observational study of patients with severe systemic inflammatory response syndrome(SIRS) and severe sepsis who were admitted to the medical intensive care unit(ICU). ScvO2 and lactate levels were measured simultaneously at the time of study enrollment, every 6 h for 24 h, and then every 24 h until the goal was reached. Results: Twenty-five patients were enrolled in the study and 13 had died and 12 had survived. There was no correlation between lactate levels and ScvO2. Neither lactate levels nor ScvO2 at the time of admission differed between non-survivors and survivors. Normalization of lactate levels within 48 h was significantly associated with survival. Conclusions: In patients with severe SIRS and severe sepsis, simultaneously measured ScvO2 and lactate levels showed no correlation, and normalization of lactate levels within 48 h was a predictive factor for survivalAbstract i Contents ii List of tables and figures iii Introduction 1 Material and Methods 3 Results 6 Discussion 13 References 17 Abstract in Korean 22Maste