339 Central Venous Oxygen Saturation is a Strong Predictor of Outcome in Patients with Cardiogenic Shock

IntroductionCentral venous oxygen saturation (SvO2) provides an accurate assessment of oxygen delivery and organs consumption balance, and correlate with outcome in extra cardiac shock. Its prognosis value has never been specifically validated in heart failure patients with cardiogenic shock.MethodsSvO2 was prospectively assessed in 27 patients (60±17 years, 17 male, LVEF=25±6%) admitted for heart failure with cardiogenic shock. SvO2 before and after 24 hours (24H SvO2) of intra-venous inotropic and diuretic support in patients with cardiogenic shock was compared to control subject with compensate heart failure (n=12) and to in hospital outcome (death and heart transplant).ResultsDuring hospitalisation period, major cardiovascular event occurred in 10 (36%) patients (6 deaths, 4 heart transplants). In patients with cardiogenic shock, admission SvO2 was lower than in patients with compensated heart failure (50±12, 66±6, 95% CI>58%) but increased after 24H of treatment (50±12, 59±8, p=0.002). Importantly, improvement in Sv02 at 24H (>58%, n=15) was associated with an excellent in hospital outcome (93%, 14/15), while a persistently low ScvO2 at 24H (< 58%) correlated with the occurrence of major cardiac adverse outcome (75%, 9/12).Furthermore, there was no difference regarding to clinical or echographical features between event free and poor outcome groups.ConclusionChange in SvO2 under intra-venous inotropic and diuretic treatment is a strong predictor of outcome in patients with cardiogenic shock.