• Petteri Holm, Tiina M Erkinaro, Jaana M Karhu, Pasi P Ohtonen, Janne H Liisanantti, Panu Taskinen, Tero I Ala-Kokko, and Timo I Kaakinen.
• Research Group of Surgery, Intensive Care Unit, Anaesthesiology and Intensive Care Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; OYS Heart, Oulu University Hospital, Research Group of Anaesthesiology, MRC Oulu and University of Oulu, Oulu, Finland. Electronic address: petteri.holm@pohde.fi.
• J. Cardiothorac. Vasc. Anesth. 2024 Feb 1; 38 (2): 423429423-429.

ObjectivesThe aim of the study was to determine if unresponsive mixed venous oxygen saturation (SvO2) values during early postoperative hours are associated with postoperative organ dysfunction.DesignA single-center retrospective observational study.SettingA university hospital.ParticipantsA total of 6,282 adult patients requiring cardiac surgery who underwent surgery in a University Hospital from 2007 to 2020.InterventionsA pulmonary artery catheter was used to gather SvO2 samples after surgery at admission to the intensive care unit (ICU) and 4 hours later. For the analysis, patients were divided into 4 groups according to their SvO2 values. The rate of organ dysfunctions categorized according to the SOFA score was then studied among these subgroups.Measurements And Main ResultsThe crude mortality rate for the cohort at 1 year was 4.3%. Multiple organ dysfunction syndrome (MODS) was present in 33.0% of patients in the early postoperative phase. During the 4-hour initial treatment period, 43% of the 931 patients with low SvO2 on admission responded to goal-directed therapy to increase SvO2 >60%; whereas, in 57% of the 931 patients, the low SvO2 was sustained. According to the adjusted logistic regression analyses, the odds ratio for MODS (4.23 [95% CI 3.41-5.25]), renal- replacement therapy (4.97 [95% CI 3.28-7.52]), time on a ventilator (2.34 [95% CI 2.17-2.52]), and vasoactive-inotropic score >30 (3.62 [95% CI 2.96-4.43]) were the highest in the group with sustained low SvO2.ConclusionsPatients with SvO2 <60% at ICU admission and 4 hours later had the greatest risk of postoperative MODS. Responsiveness to a goal-directed therapy protocol targeting maintaining or increasing SvO2 ≥60% at and after ICU admission may be beneficial.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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