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Central venous oxygen saturation as predictor of a successful spontaneous breathing trial outcome in mechanically ventilated patients

Ioannis Georgakas, Afroditi Boutou, Georgia Pitsiou, Ioannis Kioumis, Milly Bitzani, Apostolos Sgouradis, Paraskevi Argyropoulou, Ioannis Stanopoulos
European Respiratory Journal 2016 48: PA3568; DOI: 10.1183/13993003.congress-2016.PA3568
Ioannis Georgakas
1Respiratory Failure Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
3First Intensive Care Unit, “G. Papanikolaou” General Hospital, Thessaloniki, Greece
4Intensive Care Unit, General Hospital of Drama, Drama, Greece
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Afroditi Boutou
1Respiratory Failure Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Georgia Pitsiou
1Respiratory Failure Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ioannis Kioumis
2Pulmonary Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Milly Bitzani
3First Intensive Care Unit, “G. Papanikolaou” General Hospital, Thessaloniki, Greece
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Apostolos Sgouradis
4Intensive Care Unit, General Hospital of Drama, Drama, Greece
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Paraskevi Argyropoulou
1Respiratory Failure Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ioannis Stanopoulos
1Respiratory Failure Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Abstract

Rationale: Weaning from mechanical ventilation is a key element in the care of the critically ill patient and spontaneous breathing trial (SBT) is a crucial step in this procedure. This study aimed to evaluate the diagnostic accuracy of central venous oxygen saturation (ScvO2), a marker of tissue oxygenation, as a potential predictor of successful SBT.

Methods: This is a nested case-control study. A consecutive population of patients who were mechanically ventilated for ≥48h and fulfilled the initial criteria of readiness to wean, according to guidelines1, constituted the study population. All patients attempted a SBT. Patients were categorized to cases (SBT success) and controls (SBT failure), based on a combination of specific criteria1 which indicated whether SBT was successful or not. Binary logistic regression analysis was utilized to indicate independent predictors of SBT success and ROC curve was used to demonstrate diagnostic accuracy of indices.

Results: 77 patients (64.8±16.3 years; 62.3% male) constituted the study population. SBT was successful in 63.6% of them. SvO2 predicted SBT success (OR: 1.122; 95% CI:1.005-1.257) independently of age, hemoglobin concentration, arterial oxygen saturation (SaO2), arterial oxygen partial pressure (PaO2) and respiratory rate to tidal volume ratio. Diagnostic accuracy for ScvO2 alone (ROC area=0.685) was superior of that of either SaO2 (0.625) or PaO2 (0.619) alone to predict SBT success.

Conclusion: ScvO2 seems to be a useful parameter which could further facilitate the accurate categorization among those patients who pass or fail the SBT.

1 Boles J.M., et al. Eur Respir J 2007; 29: 1033–1056.

  • Mechanical ventilation - weaning
  • Critically ill patients
  • Intensive care
  • Copyright ©the authors 2016
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Central venous oxygen saturation as predictor of a successful spontaneous breathing trial outcome in mechanically ventilated patients
Ioannis Georgakas, Afroditi Boutou, Georgia Pitsiou, Ioannis Kioumis, Milly Bitzani, Apostolos Sgouradis, Paraskevi Argyropoulou, Ioannis Stanopoulos
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3568; DOI: 10.1183/13993003.congress-2016.PA3568

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Central venous oxygen saturation as predictor of a successful spontaneous breathing trial outcome in mechanically ventilated patients
Ioannis Georgakas, Afroditi Boutou, Georgia Pitsiou, Ioannis Kioumis, Milly Bitzani, Apostolos Sgouradis, Paraskevi Argyropoulou, Ioannis Stanopoulos
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3568; DOI: 10.1183/13993003.congress-2016.PA3568
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