الفهرس 
High risk surgical patientsOnly 14 pages are availabe for public view
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Abstract
Summary &Conclusion
The mortality rate in some subgroups of surgical patients is much higher than
expected for most surgical procedures, Despite the multifactorial causes of
death and organ failure in these patients, a persistent inadequacy of tissue
perfusion seems to be the most important factor for the development of
perioperative organ failure.
Early recognition and correction of warning signals of persistent
inadequacy of tissue perfusion is therefore of particular importance,
especially in patients with a reduced physiological reserve.
The inability to meet an increase in oxygen(O2) demand with surgical
trauma either by an increase in O2 delivery or an increase in O2 extraction can
lead to tissue hypoxia.
Several markers of impaired tissue oxygenation have been explored to
help identify patients at increased risk of complications. Postoperative organ
failure has been shown to be associated with reduced central venous O2
saturation (ScvO2), which explores the balance of O2 delivery and tissue O2
consumption.
However, there is evidence that O2 derived variables are poorly correlated
with anaerobic metabolism .
Indeed, both normal and high values(that is,≥75%) for ScvO2 do not exclude
the presence of tissue hypoxia in case of impaired O2 extraction capabilities,
which may therefore limit the usefulness of ScvO2 monitoring .