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2024, Number 1

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Med Crit 2024; 38 (1)

Effect of CO2 on mortality in patients with ARDS in COVID-19

González AAA, Sánchez DJS, Peniche MKG, Suárez RAA, Reyes RJM, Calyeca SMV

Language: Spanish
References: 32
Page: 20-26
PDF size: 249.85 Kb.


ABSTRACT

Introduction: severe SARS-CoV-2 pneumonia (severe acute respiratory syndrome coronavirus 2) increased the incidence of ARDS (acute respiratory distress syndrome). Protective ventilation reduces mortality in patients with ARDS; such a ventilatory strategy based on the use of low tidal volume could cause hypercapnia. CO2 (carbon dioxide) alterations are as important as oxygenation alterations in ARDS. Objective: to evaluate the effect of CO2 on mortality in patients with ARDS in COVID-19 with invasive mechanical ventilation (IMV). Material and methods: cohort, retrospective, observational, longitudinal study. It was carried out in the intensive care unit (ICU) between June 1, 2020 and December 31, 2022. Non-intervention study. Results: 115 patients were included, 61.7% men. They were classified into 3 groups according to the PaCO2 value upon admission to the ICU: group 1 (hypocapnia): PaCO2 < 35 mmHg, group 2 (normocapnia): PaCO2 35-45 mmHg, group 3 (hypercapnia): PaCO2 > 45 mmHg. Overall mortality was 53%. Group 1 presented OR 0.640 (95% CI 0.181-2.265) p = 0.488, group 2 OR1.66 (95% CI 0.673-4.130) p = 0.270 and group 3 OR 0.992 (95% CI 0.396-2.489) p = 0.98, Other variables such as ventilatory efficiency (VE) and respiratory rate (RR) presented an inverse relationship to mortality with a value of 1.4 and 24 respectively. Conclusion: PaCO2 is not a risk factor to predict mortality in patients with ARDS secondary to COVID-19 with invasive mechanical ventilation. Other variables such as ventilatory efficiency and respiratory rate are prognostic measurements in our population.


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