• Pedro M Nogueira, Hugo T Mendonça-Filho, Luiz Antonio Campos, Renato V Gomes, Alexandre R Felipe, Marco A Fernandes, Cristiane A Villela-Nogueira, and José R Rocco.
• Hospital Pró-Cardíaco, Rio de Janeiro, Brazil, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. htannus@centroin.com.br
• J Intensive Care Med. 2010 Mar 1; 25 (2): 111-6.

BackgroundCentral venous oxygen saturation (ScvO(2)) is a valuable prognostic marker in sepsis. However, its value in cardiac surgery has not been assessed yet. This study aimed at evaluating ScvO(2) as a tool for predicting short-term organ dysfunction (OD) after cardiac surgery.MethodsA prospective cohort including cardiac surgery patients submitted to a goal-oriented therapy to maintain ScvO(2) above 70% was studied. Postoperative blood samples collected at 30 minutes (T1), 6 hours (T2), and 24 hours (T3) for ScvO(2) measurement were selected to further analysis. Two groups were formed according to the absence (G0) or presence (G1) of OD defined as a Sequential Organ Failure Assessment (SOFA) score >or=5 on the third postoperative day. A logistic regression analysis was performed to identify the variables independently associated with OD on the third postoperative day.ResultsFrom the 246 patients included, 54 (22%) developed OD and were defined as G1. The mortality rates in G0 and G1 were 1.6% and 31.5%, respectively (P < .001). In the comparative analysis between G0 and G1, the ScvO(2) values were remarkably lower in G1 at T1 (66.2 +/- 9.2 vs 62.3 +/- 11.6; P = .009), T2 (69.6 +/- 5.9 vs 63.5 +/- 9.4; P ConclusionPostoperative ScvO(2) can be a valuable tool to predict OD after major cardiac surgeries. Its kinetics should be carefully followed in that setting.

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