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2024, Number 2

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Med Crit 2024; 38 (2)

Delta carbon dioxide as a predictor of mortality in the pediatric patient with septic shock

Ramírez GCD, Reséndiz SCL, López AMÁ

Language: Spanish
References: 22
Page: 93-101
PDF size: 221.30 Kb.


ABSTRACT

Introduction: monitoring of patients with septic shock seeks to evaluate parameters that reflect the microciculatory involvementand allow adjustements therapeutics. Macrohemodynamicalterations may be inconsistent with the microcirculation disorders; measurement of the arteriovenous carbon dioxide diference is suggested (delta CO2) as marker that reflects dysfunction mitochondria due to persisten oxygen debt. This determination is useful in adult patients ; this still its not verified in the patient pediatric. Material and methods: observational study carried out in the Therapy Unit Pediatric Intensive Care of de National Medical Center 20 de Noviembre. Included patients with shock septic, with take of gasometry venous and arterial to the in come,6,12 and 24 hours and assessment simultaneous os scale Pediatric Risk of Mortality (PRISM III) to assess delta-CO2 >66 mm Hg as a predictor of mortality in patients with septic shock and response evaluation therapy. Results: correlation of mortality risk was foun directly proportional to elevated delta-CO2 levels in the first 24 hours of stay in pediatric intensive care unit; presents statistical correlation positive (coefficient of correlation of Pearson 0.99 and ris relative > 1) in incresead delta CO2 levels with improvement in macrohemodynamic variables. Conclusions: delta-CO2 can be considered a prognostic factor for evolution and mortality in pediatric patients with septic shock . He require of studies with samples expanded for corroborate utility and implementation of measurement of delta-CO2 in pediatric patients. The normalization of the alteration macrocirculatory not define the improvement to level microcirculatory, evolution and forecast.


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