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01-06-2012 | Original

Knee area tissue oxygen saturation is predictive of 14-day mortality in septic shock

Authors: H. Ait-Oufella, J. Joffre, P. Y. Boelle, A. Galbois, S. Bourcier, J. L. Baudel, D. Margetis, M. Alves, G. Offenstadt, B. Guidet, E. Maury

Published in: Intensive Care Medicine | Issue 6/2012

Abstract

Purpose

Thenar eminence tissue oxygen saturation (StO₂) was developed to assess organ perfusion. However, mottling, a strong predictor of mortality in septic shock, develops preferentially around the knee. We aimed to evaluate the prognostic value of StO₂ measured around the knee in septic shock patients and compare it to thenar StO₂.

Methods

This was a prospective observational study in a tertiary teaching hospital. All consecutive patients with septic shock were included. Parameters were recorded when vasopressors were started (H0) and every 6 h during 24 h. Their predictive value was assessed on 14-day mortality.

Results

Fifty-two patients were included. SOFA score was 11 (9–15) and SAPS II was 56 (40–72). At 6 h after ICU admission (H6), mean arterial pressure, cardiac index, and central venous pressure were not different between non-survivors and survivors; but non-survivors had higher arterial lactate level (8.8 ± 5.0 vs. 2.2 ± 1.5 mmol/l, P < 0.001), lower urinary output (0.22 ± 0.45 vs. 0.70 ± 0.50 ml/kg/h, P < 0.001) and ScvO₂ (62 ± 20 vs. 72 ± 9 %, P = 0.03). At H6, StO₂ was lower in non-survivors; this difference was not significant for thenar StO₂ (70 ± 15 vs. 77 ± 12 %, P = 0.10) but was very pronounced for knee StO₂ (39 ± 23 vs. 71 ± 12 %, P < 0.001). At H6, a low knee StO₂ was associated with a higher mottling score (P < 0.01), a higher lactate level (P < 0.002, R ² = 0.2), and a lower urinary output (P = 0.02, R ² = 0.12).

Conclusion

After initial septic shock resuscitation, StO₂ measured around the knee is a strong predictive factor of 14-day mortality.

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Title: Knee area tissue oxygen saturation is predictive of 14-day mortality in septic shock
Authors: H. Ait-Oufella
J. Joffre
P. Y. Boelle
A. Galbois
S. Bourcier
J. L. Baudel
D. Margetis
M. Alves
G. Offenstadt
B. Guidet
E. Maury
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 6/2012
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-012-2555-7

At a glance: The STEP trials

Springer Medicine

Knee area tissue oxygen saturation is predictive of 14-day mortality in septic shock

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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