Intradialytic Central Venous Oxygen Saturation is Associated with Clinical Outcomes in Hemodialysis Patients

Abstract Central venous oxygen saturation (ScvO2) in the superior vena cava is predominantly determined by cardiac output, arterial oxygen content, and oxygen consumption by the upper body. While abnormal ScvO2 levels are associated with morbidity and mortality in non-uremic populations, ScvO2 has r...

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Autores principales:	Lili Chan, Hanjie Zhang, Anna Meyring-Wösten, Israel Campos, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0ff7b7a56b4c4163834437447db1e7bc
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spelling	oai:doaj.org-article:0ff7b7a56b4c4163834437447db1e7bc2021-12-02T15:05:57ZIntradialytic Central Venous Oxygen Saturation is Associated with Clinical Outcomes in Hemodialysis Patients10.1038/s41598-017-09233-x2045-2322https://doaj.org/article/0ff7b7a56b4c4163834437447db1e7bc2017-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-09233-xhttps://doaj.org/toc/2045-2322Abstract Central venous oxygen saturation (ScvO2) in the superior vena cava is predominantly determined by cardiac output, arterial oxygen content, and oxygen consumption by the upper body. While abnormal ScvO2 levels are associated with morbidity and mortality in non-uremic populations, ScvO2 has received little attention in hemodialysis patients. From 1/2012 to 8/2015, 232 chronic hemodialysis patients with central venous catheters as vascular access had their ScvO2 monitored during a 6-month baseline period and followed for up to 36 months. Patients were stratified into upper and lower two tertiles by a ScvO2 of 61.1%. Survival analysis employed Kaplan-Meier curves and adjusted Cox proportional hazards models. Patients in the lower tertiles of ScvO2 were older, had longer hemodialysis vintage, lower systolic blood pressure, lower ultrafiltration rates, higher leukocyte counts and neutrophil-to-lymphocyte ratios. Kaplan-Meier analysis indicated a shorter survival time in the lower tertiles of ScvO2 (P = 0.005, log-rank test). In adjusted Cox analysis, a 1 percent point decrease in mean ScvO2 was associated with a 4% increase in mortality (HR 1.04 [95% CI 1.01–1.08], P = 0.044), indicating that low ScvO2 is associated with poor outcomes. Research on the relative contributions of cardiac output and other factors is warranted to further elucidate the pathophysiology underlying this novel finding.Lili ChanHanjie ZhangAnna Meyring-WöstenIsrael CamposDoris FuertingerStephan ThijssenPeter KotankoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lili Chan Hanjie Zhang Anna Meyring-Wösten Israel Campos Doris Fuertinger Stephan Thijssen Peter Kotanko Intradialytic Central Venous Oxygen Saturation is Associated with Clinical Outcomes in Hemodialysis Patients
description	Abstract Central venous oxygen saturation (ScvO2) in the superior vena cava is predominantly determined by cardiac output, arterial oxygen content, and oxygen consumption by the upper body. While abnormal ScvO2 levels are associated with morbidity and mortality in non-uremic populations, ScvO2 has received little attention in hemodialysis patients. From 1/2012 to 8/2015, 232 chronic hemodialysis patients with central venous catheters as vascular access had their ScvO2 monitored during a 6-month baseline period and followed for up to 36 months. Patients were stratified into upper and lower two tertiles by a ScvO2 of 61.1%. Survival analysis employed Kaplan-Meier curves and adjusted Cox proportional hazards models. Patients in the lower tertiles of ScvO2 were older, had longer hemodialysis vintage, lower systolic blood pressure, lower ultrafiltration rates, higher leukocyte counts and neutrophil-to-lymphocyte ratios. Kaplan-Meier analysis indicated a shorter survival time in the lower tertiles of ScvO2 (P = 0.005, log-rank test). In adjusted Cox analysis, a 1 percent point decrease in mean ScvO2 was associated with a 4% increase in mortality (HR 1.04 [95% CI 1.01–1.08], P = 0.044), indicating that low ScvO2 is associated with poor outcomes. Research on the relative contributions of cardiac output and other factors is warranted to further elucidate the pathophysiology underlying this novel finding.
format	article
author	Lili Chan Hanjie Zhang Anna Meyring-Wösten Israel Campos Doris Fuertinger Stephan Thijssen Peter Kotanko
author_facet	Lili Chan Hanjie Zhang Anna Meyring-Wösten Israel Campos Doris Fuertinger Stephan Thijssen Peter Kotanko
author_sort	Lili Chan
title	Intradialytic Central Venous Oxygen Saturation is Associated with Clinical Outcomes in Hemodialysis Patients
title_short	Intradialytic Central Venous Oxygen Saturation is Associated with Clinical Outcomes in Hemodialysis Patients
title_full	Intradialytic Central Venous Oxygen Saturation is Associated with Clinical Outcomes in Hemodialysis Patients
title_fullStr	Intradialytic Central Venous Oxygen Saturation is Associated with Clinical Outcomes in Hemodialysis Patients
title_full_unstemmed	Intradialytic Central Venous Oxygen Saturation is Associated with Clinical Outcomes in Hemodialysis Patients
title_sort	intradialytic central venous oxygen saturation is associated with clinical outcomes in hemodialysis patients
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/0ff7b7a56b4c4163834437447db1e7bc
work_keys_str_mv	AT lilichan intradialyticcentralvenousoxygensaturationisassociatedwithclinicaloutcomesinhemodialysispatients AT hanjiezhang intradialyticcentralvenousoxygensaturationisassociatedwithclinicaloutcomesinhemodialysispatients AT annameyringwosten intradialyticcentralvenousoxygensaturationisassociatedwithclinicaloutcomesinhemodialysispatients AT israelcampos intradialyticcentralvenousoxygensaturationisassociatedwithclinicaloutcomesinhemodialysispatients AT dorisfuertinger intradialyticcentralvenousoxygensaturationisassociatedwithclinicaloutcomesinhemodialysispatients AT stephanthijssen intradialyticcentralvenousoxygensaturationisassociatedwithclinicaloutcomesinhemodialysispatients AT peterkotanko intradialyticcentralvenousoxygensaturationisassociatedwithclinicaloutcomesinhemodialysispatients
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Intradialytic Central Venous Oxygen Saturation is Associated with Clinical Outcomes in Hemodialysis Patients

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