High central venous oxygen saturation is associated with mitochondrial dysfunction in septic shock: A prospective...

To test the hypothesis that an impaired mitochondrial function is associated with altered central venous oxygen saturation (ScvO₂ ), venous-to-arterial carbon dioxide tension difference (delta PCO₂ ) or serum lactate in sepsis patients. This prospective cohort study was conducted in a single tertiary emergency department between April 2017 and March 2019. Patients with suspected sepsis were included in the study. Serum lactate was obtained in sepsis, ScvO₂ and delta PCO₂ were evaluated in septic shock patients. Mitochondrial function was determined from the peripheral blood mononuclear cells. Forty-six patients with suspected sepsis were included. Of these, twenty patients were septic shock. Mitochondrial oxidative stress levels were increased in the high ScvO₂ group (ScvO₂  > 80%, n = 6), compared with the normal (70%-80%, n = 9) and low ScvO₂ (<70%, n = 5) groups. A strong linear relationship was observed between the mitochondrial oxidative stress and ScvO₂ (r = .75; P = .01). However, mitochondrial respiration was increased in the low ScvO₂ group. In addition, mitochondrial complex II protein levels were significantly decreased in the high ScvO₂ group (P < .05). Additionally, there was no correlation between serum lactate, delta PCO₂ , and mitochondria oxidative stress or mitochondria function. ScvO₂ can be potentially useful for developing new therapeutics to reduce mitochondrial dysfunction in septic shock patient.