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Fluid resuscitation guided by mixed venous saturation: applicable in hypovolemic shock?

We report on an aggressive fluid resuscitation in a postoperative trauma patient with profound metabolic acidosis (pH 6.82). The patient had survived a repair of a through and through laceration of the inferior vena cava at the level of the renal veins. The amount of fluids given was guided mainly by a mixed venous blood (Sv[O.sub.2]) gas estimate obtained via a central catheter in the superior vena cava (SVC).

We monitored the pH, the base excess, the lactate level and the [O.sub.2] saturation in the SVC blood, and gave the large amount of blood products and crystalloids in order to correct the Sv[O.sub.2]. The patient recovered from the transient disseminated coagulopathy and was extubated 25 hours post ICU admission. He was discharged from ICU after 3 days and went home on day 6, fully functional.

Is the Sv[O.sub.2] a better resuscitation guide and is it applicable in hypovolaemic shock? We reviewed the literature and give the current guidelines.
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Title Annotation:Posters
Author:Allard, D.
Publication:Southern African Journal of Critical Care
Article Type:Brief article
Geographic Code:6SOUT
Date:Aug 1, 2007
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