Evaluation of the biologic importance of various hemodynamic and oxygen transport variables

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Abstract
In a series of 113 consecutively monitored, critically ill postoperative patients, predictive coefficients for each monitored hemodynamic and oxygen transport variable (parameter) were determined based on their ability to predict outcome at each stage of postoperative shock. As this predictive coefficient reflected the probability of death or survival, it was used as a criterion of the variable's clinical usefulness. The range of correct predictions by the 35 variables varied from 91–60%, but there were marked variations in their capability to predict outcome during each successive stage of postoperative shock. The commonly monitored variables, i.e., vital signs, HR, temp, central venous pressure (CVP), and Hgb, were the poorest predictors. Perfusion-related variables, which express the interrelationships of O2 transport to red cell volume and red cell flow, were among the best predictors. Blood flow, blood volume, O2 transport, and stressrelated variables were the next in order as judged by survival statistics. As the relevance of a given variable to survival or death is a criterion of its usefulness to clinical decision-making, it is appropriate to select those monitored variables that provide the desired information.

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