tailieunhanh - Báo cáo y học: "Year in review 2007: Critical Care – cardiology"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Year in review 2007: Critical Care – cardiology. | Available online http content 12 5 232 Review Year in review 2007 Critical Care - cardiology Luigi Camporota Marius Terblanche and David Bennett Adult Intensive Care Unit Guy s and St Thomas NHS Foundation Trust St Thomas Hospital 1st Floor East Wing Lambeth Palace Road London SE1 7EH UK Corresponding author Marius Terblanche Published 14 October 2008 This article is online at http content 12 5 232 2008 BioMed Central Ltd Critical Care 2008 12 232 doi cc7007 Abstract This review summarises key research papers in the fields of cardiology and intensive care published during 2007 in Critical Care. To create a context and for comparison with the papers described in the review we cite studies on the same subject published in other journals. The papers have been grouped into four categories venous oximetry cardiac surgery perioperative fluid optimisation and haemodynamic monitoring. Venous oximetry Mixed venous oxygen saturation SvO2 and central venous oxygen saturation ScvO2 - measured from the superior vena cava SVC - are used as indicators of adequacy of oxygen supply to the tissues. However obtaining SvO2 requires the insertion of a pulmonary artery catheter PAC which is invasive and is associated with an increased risk of complications 1 . ScvO2 has been used as a surrogate for SvO2 and targeting ScvO2 in the treatment of patients with severe sepsis is associated with a significant survival benefit 2 . For this reason the measurement of ScvO2 is now part of the 6-hour sepsis bundle and is recommended by the Surviving Sepsis Campaign guidelines 3 . However some questions remain Is ScvO2 an accurate reflection of SvO2 How well do they correlate What is the mechanism accounting for the observed differences between the two parameters 4-8 Generally ScvO2 is approximately 3 to 5 higher than SvO2 as oxygen saturation SO2 decreases as blood travels from the SVC to the pulmonary artery PA . The gradient varies .