The article we analyse today was written by Alan E. Jones, Nathan I. Shapiro, Stephen Trzeciak, Ryan C. Arnold, Heather A. Claremont and Jeffrey A. Kline, and published by the JAMA Network (JAMA. 2010;303(8):739-746. doi:10.1001/jama.2010.158)
Severe sepsis is a life-threatening illness affecting many people throughout the world. This study was carried out in the USA, where thousands of patients suffering from severe sepsis are hospitalised and initially treated in emergency departments every year.
The Surviving Sepsis Campaign aims to reduce mortality from sepsis and to improve its management, diagnosis and treatment. Their international consensus guidelines recommend the use of central venous oxygen saturation (ScvO2) or mixed venous oxygen saturation to assess the balance of tissue oxygen delivery and consumption.
The authors assessed various patients with severe sepsis or septic shock, and randomly assigned them to 1 of 2 resuscitation protocols. The first group was resuscitated to normalize central venous pressure, mean arterial pressure and ScvO2 of at least 70%, and the second group was resuscitated to normalize central venous pressure, mean arterial pressure, and lactate clearance of at least 10%.
After analysing the findings on their study, Jones et al. found no difference in mortality for patients suffering from severe sepsis and sepsis shock who were resuscitated with a protocol that used lactate clearance compared with a protocol that used ScvO2 as the method of measuring total body oxygen metabolism.
Please click here to access the original article:Lactate Clearance vs Central Venous Oxygen Saturation as Goals of Early Sepsis Therapy.
A Randomized Clinical Trial