<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092023000800630</article-id>
<article-id pub-id-type="doi">10.35366/115219</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Un legado de 50 años: saturación venosa central de oxígeno su utilidad en el abordaje del choque séptico]]></article-title>
<article-title xml:lang="en"><![CDATA[A 50-year legacy: central venous saturation of oxygen its usefulness in addressing septic shock]]></article-title>
<article-title xml:lang="pt"><![CDATA[Um legado de 50 anos: saturação venosa central de oxigênio e sua utilidade no tratamento do choque séptico]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Flores Romero]]></surname>
<given-names><![CDATA[Álvaro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López Fermín]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cortés Román]]></surname>
<given-names><![CDATA[Jorge Samuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Huanca Pacaje]]></surname>
<given-names><![CDATA[Juan Marcelo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital de Alta Especialidad ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>37</volume>
<numero>8</numero>
<fpage>630</fpage>
<lpage>637</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092023000800630&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092023000800630&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092023000800630&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  el choque séptico es una entidad frecuente en áreas críticas; durante el abordaje nos enfrentaremos a una toma de decisiones, que en gran porcentaje de los casos estaremos condenados a errar. La determinación clínica puede ser el primer paso; los marcadores de perfusión tisular global, como la saturación venosa central de oxígeno (SvcO2) descrita en los años 70, nos brindarán un reconocimiento temprano de un estado de perfusión inadecuada. Las intervenciones deben ser objetivas para mejora del curso, pronóstico y desenlace en la unidad de cuidados intensivos.  Objetivo:  analizar la asociación que existe entre la saturación venosa central de oxígeno (SvcO2) como un factor de riesgo de desenlace por mortalidad en una muestra de 120 pacientes con diagnóstico de choque séptico en la unidad de cuidados intensivos.  Material y métodos:  tipo de estudio analítico, transversal, observacional y retrospectivo.  Resultados:  se clasificaron como estado de choque normodinámico (SvcO2 &lt; 80%) nueve casos y como hiperdinámico (SvcO2 &#8805; 80%) 111. Se evaluaron índices de perfusión mediante un análisis multivariado: lactato (p = 0.13) 5.6 ± 1.1, delta de CO2 (p = 0.92) 9.2 ± 3.8, índice mitocondrial (p &#8804; 0.001) 1.99 ± 0.40. La mortalidad global fue 59.2% (n = 71); de los pacientes con choque séptico normodinámico, 40% tuvieron desenlace por defunción, mientras que en el grupo de choque séptico de los pacientes hiperdinámicos fueron 59% (p = 0.046). La regresión logística ajustada de la saturación venosa central de oxígeno mostró que por cada 1% por arriba de 80% incrementa el riesgo asociado a muerte 16 veces más en comparación SvcO2 menor de 80%.  Conclusiones:  la alteración del flujo sanguíneo microcirculatorio y la presencia de anaerobiosis son comunes en pacientes con estado de choque séptico y están asociados a un incremento en la mortalidad. La evaluación de la saturación venosa central de oxígeno y los índices de perfusión tisular podrían ser una ruta factible.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  septic shock is a frequent entity in critical areas, during the approach we will face decision making, which in a large percentage of cases we will be condemned and make mistakes, clinical determination can be the first step, tissue perfusion markers global, such as SvcO2 described in the 70s, will provide us with early recognition of a state of inadequate perfusion, interventions must be objective to improve the course, prognosis and outcome in the intensive care unit.  Objective:  to analyze the association between central venous oxygen saturation (SvcO2) as a risk factor for mortality outcomes in a sample of 120 patients diagnosed with septic shock in the intensive care unit.  Material and methods:  type of analytical, cross-sectional, observational and retrospective study.  Results:  shock was classified as normodynamic (SvcO2 &lt; 80%) (n = 9) and hyperdynamic (SvcO2 &#8805; 80%) (n = 111). Perfusion indices were evaluated by a multivariate analysis (lactate (p = 0.13) 5.6 ± 1.1, delta CO2 (p = 0.92) 9.2 ± 3.8, mitochondrial index (p &#8804; 0.001) 1.99 ± 0.40; overall mortality 59.2% (n = 71) of the patients with normodynamic septic shock, 40% had an outcome due to death, while, in the septic shock group of hyperdynamic patients, it was 59% (p = 0.046). Central venous oxygen; for every 1 above 80% the risk associated with death increases 16 times more compared to less than 80%.  Conclusions:  the alteration of microcirculatory blood flow and the presence of anaerobiosis are common in patients with septic shock and are associated with an increase in mortality. The evaluation of central venous oxygen saturation and tissue perfusion indices could be a feasible route.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  o choque séptico é uma entidade frequente em áreas críticas, durante a abordagem enfrentaremos tomadas de decisão, que em uma grande porcentagem de casos estaremos condenados a errar, a determinação clínica pode ser o primeiro passo, marcadores de perfusão tecidual globais, como SvcO2 descrita na década de 70, nos fornecerão o reconhecimento precoce de um estado de perfusão inadequada, as intervenções devem ser objetivas para melhorar o curso, o prognóstico e o resultado na unidade de terapia intensiva.  Objetivo:  analisar a associação entre a saturação venosa central de oxigênio (SvcO2) como fator de risco para desfechos de mortalidade em uma amostra de 120 pacientes com diagnóstico de choque séptico na unidade de terapia intensiva.  Material e métodos:  tipo de estudo analítico, transversal, observacional e retrospectivo.  Resultados:  eles foram classificados como estado de choque normodinâmico (SvcO2 &lt; 80%) (n = 9) e hiperdinâmico (SvcO2 &#8805; 80%) (n = 111). Os índices de perfusão foram avaliados por análise multivariada (lactato (p = 0.13) 5.6 ± 1.1, delta CO2 (p = 0.92) 9.2 ± 3.8, índice mitocondrial (p &#8804; 0.001) 1.99 ± 0.40; mortalidade geral 59.2% (n = 71) dos pacientes com choque séptico normodinâmico, 40% tiveram desfecho por óbito, enquanto no grupo de choque séptico de pacientes hiperdinâmicos, foi de 59% (p = 0.046). A regressão logística ajustada da saturação venosa central de oxigênio; para cada 1% acima de 80%, aumenta o risco associado à morte 16 vezes mais em comparação com menos de 80%.  Conclusões:  a alteração do fluxo sanguíneo microcirculatório e a presença de anaerobiose são comuns em pacientes com choque séptico e estão associadas ao aumento da mortalidade. A avaliação da saturação venosa central de oxigênio e dos índices de perfusão tecidual poderia ser um caminho viável.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[perfusión tisular]]></kwd>
<kwd lng="es"><![CDATA[choque séptico]]></kwd>
<kwd lng="es"><![CDATA[saturación venosa central]]></kwd>
<kwd lng="es"><![CDATA[sala de urgencias]]></kwd>
<kwd lng="es"><![CDATA[índice mitocondrial]]></kwd>
<kwd lng="en"><![CDATA[tissue perfusion]]></kwd>
<kwd lng="en"><![CDATA[septic shock]]></kwd>
<kwd lng="en"><![CDATA[central venous saturation]]></kwd>
<kwd lng="en"><![CDATA[emergency room]]></kwd>
<kwd lng="en"><![CDATA[mitochondrial index]]></kwd>
<kwd lng="pt"><![CDATA[perfusão tecidual]]></kwd>
<kwd lng="pt"><![CDATA[choque séptico]]></kwd>
<kwd lng="pt"><![CDATA[saturação venosa central]]></kwd>
<kwd lng="pt"><![CDATA[pronto-socorro]]></kwd>
<kwd lng="pt"><![CDATA[índice mitocondrial]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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