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Date Published: 31/08/2023
Online Published: 31/07/2023
Abstract Views: 109
Views PDF: 95
DOI: https://doi.org/10.58490/ctump.2023i62.655
Issue
No. 62 (2023)
Section
Article
How to Cite
Ngo, N. L. T., Vo, M. P., & Doan, D. N. (2023). MORTALITY PROGNOSTIC VALUE OF CENTRAL VENOUS - ARTERIAL CO2 PARTIAL PRESSURE DIFFERENCE OF SEPTIC SHOCK PATIENTS. Cantho Journal of Medicine and Pharmacy, 62, 83-90. https://doi.org/10.58490/ctump.2023i62.655

MORTALITY PROGNOSTIC VALUE OF CENTRAL VENOUS - ARTERIAL CO2 PARTIAL PRESSURE DIFFERENCE OF SEPTIC SHOCK PATIENTS

Ngo Nguyen Lien Trang1,, Vo Minh Phuong1, Duc Nhan Doan1
1 Can Tho University of Medicine and Pharmacy

Main Article Content

Abstract

Background: Severe sepsis and septic shock are major healthcare problems, affecting millions of individuals around the world each year. Central venous- aterial CO2 partial pressure difference values ΔPCO2 to be associated with poorer clinical outcomes, including worsened hemodynamic parameters, poorer tissue perfusion, and greater in hospital mortality. Objectives: To describe the clinical, laboratory characteristics and mortality prognostic value of ΔPCO2 of septic shock patients. Materials and method: A descriptive cross-sectional study on 77 patients who were diagnosed with septic shock from March 2022 - March 2023 at Intensive Care Unit of Can Tho Central General Hospital. Results: The majority of patients was female (55.8%), with the median age was 64 years old. The most common infection tracts which cause septic shock were respiratory tract (48.1%) and gastrointestinal tract (37.7%). The outcome of septic shock treatment was with 75.3% mortality and 24.7% stabe. In patients with septic shock ΔPCO2 cut point 6.25mmHg, the area under the curve was 0.815 with high prognostic mortality sensitivity was 86.2%, specificity was 68.4%. Group ΔPCO2 T6 >=6.25mmHg has higher mortality rate than group ΔPCO2 T6 <6mmHg 3.49 times with positive predictive value was 83% and negative predictive value was 41.6%. Conclusion: Central venous - aterial CO2 pressure at T6 may be an effective tool for prognostic mortality for patients with septic shock. Patients with ΔPCO2 T6 >=6.25mmHg should be monitored and treated intensively.

Article Details

Keywords

septic shock, prognostic, PvaCO2, ΔPCO2

References

1. Dellinger R, Phillip Dellinger , Mitchell M, Jean M, Julian B, Margaret M, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, Crit Care Med. 2008. 36(1), 296-327, http://doi.org/10.1097/01.CCM.0000298158.12101.41.
2. Phillip Dellinger, Mitchell M, Andrew Rhodes, Djillali Annane, Herwig Gerlach, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock:2012, Crit Care Med. 2013. 41(2), 580-637, http://doi.org/10.1097/CCM.0b013e31827e83af.
3. Paul A van Beest , Mariska C Lont, Nicole D Holman, Bert Loef, Michaël A Kuiper, et al, Central venous-arterial pCO2 difference as a tool in resuscitation of septic patient, Intensive Care Med. 2013. 39(6), 1034-39, http://doi.org/10.1007/s00134-013-2888-x.
4. Mallat Jihad, Pepy Florent, Malcolm Lemyze, Gaëlle Gasan, Nicolas Vangrunderbeeck, et al, Central venous-to-arterial carbon dioxide partial pressure difference in early resuscitation from septic shock: a prospective observational study, Eur J Anaesthesiol, 2014. 371-380, http://doi.org/10.1097/EJA.0000000000000064.
5. Dương Thiện Phước. Nghiên cứu nguyên nhân, một số yếu tố liên quan đến mức độ nặng và đánh giá kết quả điều trị choáng nhiễm trùng tại khoa Hồi sức tích cực- Chống độc Bệnh viện Đa khoa Trung Ương Cần Thơ năm 2016-2017, Luận án Chuyên khoa cấp II, Trường Đại học Y Dược Cần Thơ. 2017.
6. Nguyễn Trần Trọng Phú. Nghiên cứu đặc điểm lâm sàng, cận lâm sàng, mức độ choáng và đánh giá kết quả điều trị bệnh nhân choáng nhiễm trùng tại Bệnh viện Đa khoa Trung Ương Cần Thơ năm 2016-2018, Luận văn Bác sĩ Nội trú, Trường Đại học Y Dược Cần Thơ. 2018.
7. Danh Minh Sung. Nghiên cứu cứu đặc điểm lâm sàng, cận lâm sàng, kết quả điều trị sốc nhiễm khuẩn và giá trị tiên lượng của độ thanh thải lactate máu tại Bệnh viện Đa khoa tỉnh Kiên Giang năm 2021-2022, Luận án Chuyên khoa cấp II, Trường Đại học Y Dược Cần Thơ. 2022.
8. Walid Mohamed Kamel, Ramy Mohamed El Sayed Ibrahim, Dalia Mohamed, Mohamed Ibrahim. Anaerobic Metabolism Markers as a Guide of Resuscitation Effort and Mortality Benefit in Septic Shock Among Egyptian Population. The Egyptian Journal of Critical Care Medicine. 2020. 7(1), 17-25, http://doi.org/10.1097/EJ9.0000000000000002.
9. Helmy TA, Ghazy FG El Rewen, Farahat Gomaa Ghazy. Prognostic Value of Venous to Arterial Carbon Dioxide Difference during Early Resuscitation in Critically Ill Patients with Septic Shock. Indian J Crit Care Med. 2017. 21, 589-593, http://doi.org/10.4103/ijccm.IJCCM_64_16.
10. Walid Ahmed and Laimoud M. The Value of Combining Carbon Dioxide Gap and OxygenDerived Variables with Lactate Clearance in Predicting Mortality after Resuscitation of Septic Shock Patients. Crit Care Res Pract. 2021. 25, http://doi.org/10.1155/2021/6918940.
11. Amr Mohamed, Adel Mohamed Alansary, Mohamed Abd-AlSalam Al-Gendy, Hala Salah ElDin El-Ozairy, Mohamed Hosny Abdulla, et al. Combination of central vero - arterial carbon dioxide gap with arterio - venous oxygen content difference during resuscitation as a predictor of multi-organ dysfuntion in septic patients. Ain shams medical journal. 2019. 70, 735-745, http://doi.org/10.21608/ASMJ.2019.101285.