In a shock patient, good clinical indicator of perfusion status among the following is
Correct Answer: Mixed venous oxygen saturation
Description: Urine output is a good measure of organ perfusion and the best monitor of the adequacy of shock therapy. However, this is an hourly measure and does not give a minute-to-minute view of the shocked state. The level of consciousness is an impoant marker of cerebral perfusion, but brain perfusion is maintained until the very late stages of shock, and hence is a poor marker of adequacy of resuscitation.Currently, the only clinical indicators of perfusion of the gastrointestinal tract and muscular beds are the global measures of lactic acidosis (lactate and base deficit) and the mixed venous oxygen saturation. There is no 'normal' central venous pressure (CVP) for a shocked patient, and reliance cannot be placed on an individual pressure measurement to assess volume status. Some patients may require a CVP of 5 cmH2O, whereas some may require a CVP of 15 cmH2O or higher.Bailey and love 27e pg: 16
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