Value of central venous to arterial CO2 difference after early goal-directed therapy in septic shock patients
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/215039 |
Resumo: | Background and aims: Venous to arterial difference of carbon dioxide (Pv–aCO2) tracks tissue blood flow. We aimed to evaluate if Pv–aCO2 measured from a superior central vein sample is a prognostic index (ICU length of stay, SOFA score, 28th mortality rate) just after early goal-directed therapy (EGDT)comparing its ICU admission values between patients with normal and abnormal (>6 mm Hg) Pv–aCO2. As secondary objectives, we evaluated the relationship of Pv–aCO2 with other variables of perfusion during the 24 hours that followed EGDT. Materials and methods: Prospective observational study conducted in an academic ICU adult septic shock patients after a 6-hour complete EGTD. Hemodynamic measurements, arterial/central venous blood gases, and arterial lactate were obtained on ICU admission and after 6, 18 and 24 hours. Results: Sixty patients were included. Admission Pv–aCO2 values showed no prognostic value. Admission Pv–aCO2 (ROC curve 0.527 [CI 95% 0.394 to 0.658]) values showed low specificity and sensitivity as predictors of mortality. There was a difference observed in the mean Pv–aCO2 between nonsurvivors (NS) and survivors (S) after 6 hours. Central venous oxygen saturation (ScvO2) and Pv–aCO2 showed significant correlation (R2 = –0.41, P < 0.0001). Patients with normal ScvO2 (>70%) and abnormal Pv–aCO2 (>6 mm Hg) showed higher SOFA scores. Normal Pv–aCO2 group cleared their lactate levels in comparison to the abnormal Pv–aCO2 group. Conclusion: In septic shock, admission Pv–aCO2 after EGDT is not related to worse outcomes. An abnormal Pv–aCO2 along with a normal ScvO2 is related to organ dysfunction. |
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Araujo, David TheophiloFelice, Vinicius BrennerMeregalli, André FelipeFriedman, Gilberto2020-11-14T04:22:40Z20191998-359Xhttp://hdl.handle.net/10183/215039001117872Background and aims: Venous to arterial difference of carbon dioxide (Pv–aCO2) tracks tissue blood flow. We aimed to evaluate if Pv–aCO2 measured from a superior central vein sample is a prognostic index (ICU length of stay, SOFA score, 28th mortality rate) just after early goal-directed therapy (EGDT)comparing its ICU admission values between patients with normal and abnormal (>6 mm Hg) Pv–aCO2. As secondary objectives, we evaluated the relationship of Pv–aCO2 with other variables of perfusion during the 24 hours that followed EGDT. Materials and methods: Prospective observational study conducted in an academic ICU adult septic shock patients after a 6-hour complete EGTD. Hemodynamic measurements, arterial/central venous blood gases, and arterial lactate were obtained on ICU admission and after 6, 18 and 24 hours. Results: Sixty patients were included. Admission Pv–aCO2 values showed no prognostic value. Admission Pv–aCO2 (ROC curve 0.527 [CI 95% 0.394 to 0.658]) values showed low specificity and sensitivity as predictors of mortality. There was a difference observed in the mean Pv–aCO2 between nonsurvivors (NS) and survivors (S) after 6 hours. Central venous oxygen saturation (ScvO2) and Pv–aCO2 showed significant correlation (R2 = –0.41, P < 0.0001). Patients with normal ScvO2 (>70%) and abnormal Pv–aCO2 (>6 mm Hg) showed higher SOFA scores. Normal Pv–aCO2 group cleared their lactate levels in comparison to the abnormal Pv–aCO2 group. Conclusion: In septic shock, admission Pv–aCO2 after EGDT is not related to worse outcomes. An abnormal Pv–aCO2 along with a normal ScvO2 is related to organ dysfunction.application/pdfengIndian journal of critical care medicine. New Dehli. vol. 23, no. 10 (2019), p. 449-453Choque sépticoPressao venosa centralMortalidadeDióxido de carbonoCentral venous saturationLactateMortalitySeptic shockVenous to arterial difference of CO2Value of central venous to arterial CO2 difference after early goal-directed therapy in septic shock patientsEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001117872.pdf.txt001117872.pdf.txtExtracted Texttext/plain28243http://www.lume.ufrgs.br/bitstream/10183/215039/2/001117872.pdf.txt05dee1e0d8e6322284e1a48d07ad3791MD52ORIGINAL001117872.pdfTexto completo (inglês)application/pdf541492http://www.lume.ufrgs.br/bitstream/10183/215039/1/001117872.pdffce1f9d029f1c7b67ff2ebd1552111b6MD5110183/2150392020-11-15 05:11:41.295008oai:www.lume.ufrgs.br:10183/215039Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2020-11-15T07:11:41Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Value of central venous to arterial CO2 difference after early goal-directed therapy in septic shock patients |
title |
Value of central venous to arterial CO2 difference after early goal-directed therapy in septic shock patients |
spellingShingle |
Value of central venous to arterial CO2 difference after early goal-directed therapy in septic shock patients Araujo, David Theophilo Choque séptico Pressao venosa central Mortalidade Dióxido de carbono Central venous saturation Lactate Mortality Septic shock Venous to arterial difference of CO2 |
title_short |
Value of central venous to arterial CO2 difference after early goal-directed therapy in septic shock patients |
title_full |
Value of central venous to arterial CO2 difference after early goal-directed therapy in septic shock patients |
title_fullStr |
Value of central venous to arterial CO2 difference after early goal-directed therapy in septic shock patients |
title_full_unstemmed |
Value of central venous to arterial CO2 difference after early goal-directed therapy in septic shock patients |
title_sort |
Value of central venous to arterial CO2 difference after early goal-directed therapy in septic shock patients |
author |
Araujo, David Theophilo |
author_facet |
Araujo, David Theophilo Felice, Vinicius Brenner Meregalli, André Felipe Friedman, Gilberto |
author_role |
author |
author2 |
Felice, Vinicius Brenner Meregalli, André Felipe Friedman, Gilberto |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Araujo, David Theophilo Felice, Vinicius Brenner Meregalli, André Felipe Friedman, Gilberto |
dc.subject.por.fl_str_mv |
Choque séptico Pressao venosa central Mortalidade Dióxido de carbono |
topic |
Choque séptico Pressao venosa central Mortalidade Dióxido de carbono Central venous saturation Lactate Mortality Septic shock Venous to arterial difference of CO2 |
dc.subject.eng.fl_str_mv |
Central venous saturation Lactate Mortality Septic shock Venous to arterial difference of CO2 |
description |
Background and aims: Venous to arterial difference of carbon dioxide (Pv–aCO2) tracks tissue blood flow. We aimed to evaluate if Pv–aCO2 measured from a superior central vein sample is a prognostic index (ICU length of stay, SOFA score, 28th mortality rate) just after early goal-directed therapy (EGDT)comparing its ICU admission values between patients with normal and abnormal (>6 mm Hg) Pv–aCO2. As secondary objectives, we evaluated the relationship of Pv–aCO2 with other variables of perfusion during the 24 hours that followed EGDT. Materials and methods: Prospective observational study conducted in an academic ICU adult septic shock patients after a 6-hour complete EGTD. Hemodynamic measurements, arterial/central venous blood gases, and arterial lactate were obtained on ICU admission and after 6, 18 and 24 hours. Results: Sixty patients were included. Admission Pv–aCO2 values showed no prognostic value. Admission Pv–aCO2 (ROC curve 0.527 [CI 95% 0.394 to 0.658]) values showed low specificity and sensitivity as predictors of mortality. There was a difference observed in the mean Pv–aCO2 between nonsurvivors (NS) and survivors (S) after 6 hours. Central venous oxygen saturation (ScvO2) and Pv–aCO2 showed significant correlation (R2 = –0.41, P < 0.0001). Patients with normal ScvO2 (>70%) and abnormal Pv–aCO2 (>6 mm Hg) showed higher SOFA scores. Normal Pv–aCO2 group cleared their lactate levels in comparison to the abnormal Pv–aCO2 group. Conclusion: In septic shock, admission Pv–aCO2 after EGDT is not related to worse outcomes. An abnormal Pv–aCO2 along with a normal ScvO2 is related to organ dysfunction. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019 |
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2020-11-14T04:22:40Z |
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http://hdl.handle.net/10183/215039 |
dc.identifier.issn.pt_BR.fl_str_mv |
1998-359X |
dc.identifier.nrb.pt_BR.fl_str_mv |
001117872 |
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1998-359X 001117872 |
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http://hdl.handle.net/10183/215039 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
Indian journal of critical care medicine. New Dehli. vol. 23, no. 10 (2019), p. 449-453 |
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info:eu-repo/semantics/openAccess |
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