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Issue: No. 101 (2026)
Section: Article
DOI: 10.58490/ctjump.2026i101.5062
Date Published: 20/08/2026
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Le, T. C. H., Vo, M. P., & Nguyen, T. B. T. (2026). PROGNOSTIC VALUE OF CENTRAL VENOUS–ARTERIAL CARBON DIOXIDE PARTIAL PRESSURE DIFFERENCE AND LACTATE CLEARANCE IN SEPTIC SHOCK PATIENTS. Cantho Journal of Medicine and Pharmacy, 101, 1-7. https://doi.org/10.58490/ctjump.2026i101.5062

PROGNOSTIC VALUE OF CENTRAL VENOUS–ARTERIAL CARBON DIOXIDE PARTIAL PRESSURE DIFFERENCE AND LACTATE CLEARANCE IN SEPTIC SHOCK PATIENTS

Thi Cam Hong Le1, , Minh Phuong Vo2, Thanh Bich Thao Nguyen1
1 Can Tho General Hospital
2 Can Tho University of Medicine and Pharmacy

Main Article Content

Abstract

Background: In septic shock resuscitation, the assessment of tissue perfusion and early prognostication remains challenging. Therefore, determining the prognostic value of the central venous-to-arterial carbon dioxide partial pressure difference (ΔPCO₂) and lactate clearance may help optimize hemodynamic monitoring and guide therapeutic strategies. Objectives: To determine the prognostic value of ΔPCO₂ and lactate clearance in patients with septic shock. Materials and methods:  A cross-sectional descriptive study was conducted on 47 patients aged ≥ 16 years diagnosed with septic shock according to the Surviving Sepsis Campaign (SSC) 2016 criteria. ΔPCO₂ was defined as the difference between central venous PCO₂ and arterial PCO₂ measured simultaneously. Demographic characteristics, source of infection, SOFA score, APACHE II score, norepinephrine dose, mechanical ventilation status, and in-hospital mortality were recorded. ΔPCO₂ and lactate clearance were assessed at diagnosis (T0), after 6 hours (T6), and after 12 hours (T12) of resuscitation. Results: Among the 47 enrolled patients, the in-hospital mortality rate was 55.3%. Patients who died had significantly higher ΔPCO₂ values at all three time points compared with survivors. Similarly, lactate clearance was significantly higher in survivors than in nonsurvivors at both T6 and T12 (p<0.001). ΔPCO₂ at T0 and T6 demonstrated good prognostic performance for in-hospital mortality, with an area under the receiver operating characteristic curve (AUC) of 0.86 (95% CI: 0.75–0.97 and 0.74–0.98, respectively). Lactate clearance at T12 showed the best prognostic performance, with an AUC of 0.92 (95% CI: 0.84–1.00). Conclusions: ΔPCO₂ and lactate clearance during the first 12 hours of resuscitation showed good prognostic value for predicting in-hospital mortality in patients with septic shock. 

Keywords

Septic shock, ∆PCO₂, lactate clearance

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