Variation in central venous oxygen saturation to evaluate fluid responsiveness: a systematic review and meta-analysis

作者：Jianneng Pan, Yuxiang Sun, Zhaojun Xu, Pingping Dong, Xiaoyang Zhou · 发表于：Critical Care · 年份：2023 · DOI：10.1186/s13054-023-04480-z · 被引用次数：8 · 研究领域：Hemodynamic Monitoring and Therapy、Sepsis Diagnosis and Treatment、Respiratory Support and Mechanisms

Abstract Background Since oxygen content and oxygen consumption typically remain unchanged within a short period, variation in central venous oxygen saturation (ΔScvO 2 ) during fluid challenge can theoretically track the changes in cardiac output (CO). We conducted this meta-analysis to systematically assess the diagnostic performance of ΔScvO 2 during a fluid challenge for fluid responsiveness in mechanically ventilated patients receiving volume expansion. Methods Electronic databases were systematically searched to identify relevant studies published before October 24, 2022. As the cutoff value of ΔScvO 2 was expected to vary across the included studies, we estimated the area under the hierarchical summary receiver operating characteristic curve (AUHSROC) as the primary measure of diagnostic accuracy. The optimal threshold of ΔScvO 2 and the corresponding 95% confidential interval (CI) were also estimated. Results This meta-analysis included 5 observational studies comprising 240 participants, of whom 133 (55%) were fluid responders. Overall, the ΔScvO 2 during the fluid challenge exhibited excellent performance for defining fluid responsiveness in mechanically ventilated patients receiving volume expansion, with an AUHSROC of 0.86 (95% CI 0.83–0.89), a pooled sensitivity of 0.78 (95% CI 0.69–0.85), a pooled specificity of 0.84 (95% CI 0.72–0.91), and a pooled diagnostic odds ratio of 17.7 (95% CI 5.9–53.2). The distribution of the cutoff values was nearly conically symmet...