[Central venous oxygen saturation as a resuscitation goal for patients with severe sepsis should be examined closely].

Fluids, vasopressors and inotropics are mainstays in the initial treatment of sepsis. Consensus guidelines recommend a central venous oxygen saturation (ScvO(2)) larger than 69% as a resuscitation goal for sepsis treatment. Several studies demonstrate that many patients with sepsis have normal or higher ScvO(2) and this may lead to inappropriate use of vasopressors or inotropics when the patient is still in need of fluid. We discuss the (patho)physiology of ScvO(2) in sepsis and propose individualized fluid therapy based on optimization of cardiac preload, e.g. by establishing a maximal ScvO(2).