• Junji Kumasawa, Akitoshi Ohara, Hisakazu Kohata, Kenichi Aoyagi, Shingo Fukuma, and Shunichi Fukuhara.
• Department of Healthcare Epidemiology, School of Public Health, Kyoto University Faculty of Medicine, Yoshidakonoe-cho, Sakyo-ku, Kyoto City, Japan 606-8315; Department of Critical Care Medicine, Sakai City Medical Center, Ebaraji-cho 1-1-1, Nishi-ku, Sakai City, Japan 593-8304. Electronic address: jkumakumakuma@hotmail.com.
• J Crit Care. 2016 Jun 1; 33: 257-61.

ObjectiveThe objective was to determine whether central-venous oxygen saturation (ScvO2<70%) can be detected from the difference between invasively and noninvasively measured systolic blood pressure (BP) (ie, ΔBP defined as arterial BP minus noninvasive BP).MethodsThis is a cross-sectional study at a single medical and surgical intensive care unit in Japan. All hypotensive patients admitted to intensive care unit were eligible. Arterial BP was measured via a radial-artery catheter, and noninvasive BP on the same side was measured via a brachial cuff. ScvO2 was measured by gas analysis of blood sampled from a central-venous chatheter (CVC). We calculate the area under the curve for ΔBP as an indicator of ScvO2<70%.ResultsUsable data were obtained from the records of 111 patients. The median and interquartile range of ΔBP and ScvO2 were -4mm Hg (-11, 6) and 67% (60.9, 73.9), respectively. The area under the curve of ΔBP as an indicator of ScvO2<70% was 0.81 (95% confidence interval [CI], 0.73-0.89). With a cutoff ΔBP of 0, sensitivity was 65.7% (95% CI, 53.1-76.8), specificity was 97.7% (95% CI, 88.0-99.8), and positive predictive value was 97.8 (95% CI, 88.2-99.9).ConclusionsΔBP can indicate whether ScvO2 is lower than 70%. When that difference is greater than 0, ScvO2 is very likely to be lower than 70%.Copyright © 2016 Elsevier Inc. All rights reserved.

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