Difference between Partial Pressure of Venous to Arterial Carbon Dioxide as a Mortality Indicator in Septic Shock Patients After Early Goal Directed Therapy: A Prospective Observational Study
Authors/Creators
- 1. Fellow SR Emergency Critical Care, Department of Trauma and Emergency, IGIMS, Patna, Bihar, India
- 2. Assistant Professor, Department of Trauma and Emergency, IGIMS, Patna, Bihar, India
Description
Abstract
Aim: The aim of the present study was to evaluate if partial pressure of CO2 measured from a superior central
vein sample is a prognostic index (ICU length of stay, SOFA score, 28th mortality rate) just after early goaldirected therapy (EGDT).
Methods: The present study was conducted at Department of Trauma and Emergency .The study population
consisted of adult (≥18 years) septic patients admitted to the intensive care unit after EGTD that persisted with
shock (need for vasopressors). During a 6-month period, a total of 100 patients were analyzed.
Results: Survivors showed a significant reduction in SOFA score during 3 days follow-up. The admission Pv–
aCO2 showed no difference with regard to any possible outcome when categorized in normal and abnormal.
Admission Pv–aCO2, ScvO2 and arterial lactate values showed low specificity and sensitivity to predict mortality.
Normal or abnormal Pv–aCO2 values in each time did not show statistical difference for 28th mortality, ICU
mortality and SOFA scores. Patients with normal ScvO2 values but with enlarged Pv–aCO2 showed higher SOFA
score values during follow-up.
Conclusion: This study showed that the admission Pv–aCO2 after EGDT is not associated with worse outcomes.
The possible physiologic explanation is that blood flow was restored for most patients. In the future, studies with
larger numbers of patients may demonstrate that Pv–aCO2 could be a useful complementary perfusion clinical
parameter and help identify patients who remain inadequately managed when the hemodynamic optimization has
been reached.
Abstract (English)
Abstract
Aim: The aim of the present study was to evaluate if partial pressure of CO2 measured from a superior central
vein sample is a prognostic index (ICU length of stay, SOFA score, 28th mortality rate) just after early goaldirected therapy (EGDT).
Methods: The present study was conducted at Department of Trauma and Emergency .The study population
consisted of adult (≥18 years) septic patients admitted to the intensive care unit after EGTD that persisted with
shock (need for vasopressors). During a 6-month period, a total of 100 patients were analyzed.
Results: Survivors showed a significant reduction in SOFA score during 3 days follow-up. The admission Pv–
aCO2 showed no difference with regard to any possible outcome when categorized in normal and abnormal.
Admission Pv–aCO2, ScvO2 and arterial lactate values showed low specificity and sensitivity to predict mortality.
Normal or abnormal Pv–aCO2 values in each time did not show statistical difference for 28th mortality, ICU
mortality and SOFA scores. Patients with normal ScvO2 values but with enlarged Pv–aCO2 showed higher SOFA
score values during follow-up.
Conclusion: This study showed that the admission Pv–aCO2 after EGDT is not associated with worse outcomes.
The possible physiologic explanation is that blood flow was restored for most patients. In the future, studies with
larger numbers of patients may demonstrate that Pv–aCO2 could be a useful complementary perfusion clinical
parameter and help identify patients who remain inadequately managed when the hemodynamic optimization has
been reached.
Files
Files
(380.3 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:2094cfe885d5a293f7504272795d7ded
|
380.3 kB | Download |
Additional details
Dates
- Accepted
-
2024-01-24