Using lactate in lieu of central venous oxygenation for sepsis resuscitation

16 Dec

In the well known Rivers Protocol for Early Goal Directed Sepsis therapy central venous oxygenation (ScvO2) is one of the goals.

In the emergency department ScvO2 is difficult to obtain. Lactates are not.

A non-inferiority study was published in JAMA in 2010 regarding this topic.

  • 300 patients were randomly allocated to either ScvO2 monitoring or serial lactates.
  • ScvO2 group was resuscitated to normalize CVP, MAP, and ScvO2 of at least 70%
  • lactate clearance group was resuscitated to normalize CVP, MAP, and lactate clearance of at least 10%.


  • no significant differences between groups in regard to in-hospital mortality.



In the ED, you can use lactate in lieu of central venous oxygenation as a goal/marker for sepsis resuscitation


Submitted by K. Sullivan.


References: Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010 Feb 24; 303 (8): 739-46; picture




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