Comparison of Intermittent versus Continuous Superior Venal Caval Oxygen Saturation Monitoring in Early Goal Directed Therapy in Septic Shock: A Systematic Review

Jhuma Mondal Sankar; Rashmi Ranjan Das; Udhaya Vijaya Kumar

doi:10.1055/s-0041-1729742

Journal of Pediatric Intensive Care, Table of Contents

J Pediatr Intensive Care 2022; 11(04): 267-274
DOI: 10.1055/s-0041-1729742

Review Article

Comparison of Intermittent versus Continuous Superior Venal Caval Oxygen Saturation Monitoring in Early Goal Directed Therapy in Septic Shock: A Systematic Review

Jhuma Mondal Sankar

¹Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India

,

Rashmi Ranjan Das

²Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, India

,

Udhaya Vijaya Kumar

¹Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India

› Author Affiliations

Abstract

Early goal directed therapy (EGDT) is a bundle of care (monitoring ScvO₂ and lactate along with clinical parameters and instituting therapy) that has shown to improve outcomes in patients with septic shock. We conducted a systematic review of clinical trials and observational studies to compare intermittent versus continuous monitoring of ScvO₂. We did major database searches till August 2020. Hospitalized children (>2 months age) and adults with septic shock were included. The intervention was “intermittent ScvO₂ monitoring,” and the comparator was “continuous ScvO₂ monitoring.” The primary outcome is “all-cause mortality.” Of 564 citations, 3 studies (n = 541) including both children and adults were included in the analysis. There was no significant difference in the “overall/all-cause mortality” (two randomized controlled trials; 258 participants) between the “intermittent” and “continuous” ScvO₂ monitoring groups (relative risk [RR]: 1.00; 95% confidence interval [CI]: 0.8–1.24). However, a single observational study (283 participants) showed a significant increase in mortality in the intermittent group (RR: 1.46; 95% CI: 1.03–2.05). The GRADE evidence generated for “overall/all-cause mortality” was of “moderate certainty.” To conclude, the present meta-analysis did not find any significant difference between “intermittent” and “continuous” ScvO₂ monitoring in patients with septic shock.

Keywords

goal directed therapy - ScvO₂ monitoring - sepsis - septic shock - mortality

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References

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