Directive value of lactate clearance and central venous oxygen saturation in the patients with severe sepsis or septic shock

Objective To evaluate the efficacy of the lactate clearance and central venous oxygen saturation (ScvO2)directed therapy in severe sepsis and septic shock. Methods According to the goal of therapy, 74 patients with severe sepsis or septic shock admitted between January 2006 and December 2006 at the Department of ICU, the First Hospital of China Medical University were assigned into three groups: A group (fluid resuscitation for 72 hours); B group(fluid resuscitation and ScvO2 ≥ 70% for 72 hours); C group (fluid resuscitation and lactate clearance ≥ 10% for 72 hours). Results The rates of MODS in B group and C group were lower than that in C group (33.3% vs 54.5%; 28.6% vs 54.5%, P0.05). Mortality rate at 7 day in C group was lower than that in A group (P0.05). Mortality rates in B group and C group were lower than that in A group. Time of stay in ICU in B group and C group were shorter than that in A group (P0.05). Conclusion Therapy directed by lactate clearance and ScvO2 is associated with decreased mortality rate and rate of MODS in patients with severe sepsis or septic shock.