Fuentes GAJ, Monares ZE, Ochoa MX, Franco GJ

Language: Spanish
References: 19
Page: 255-260
PDF size: 220.45 Kb.

ABSTRACT

Introduction: The venoarterial CO₂ difference has been associated with low cardiac-output states. Its association with arteriovenous O₂ content difference (DvaCO₂/DavO₂) is proposed as a non-invasive marker of tissue hypoperfusion, but its impact over mortality in critical care patients is uncertain. Objective: To determine the ability of DvaCO₂/DavO₂ to guide the resuscitation and predict the mortality of critical patients in shock status at zero, 24, and 48 hours. Material and methods: Retrospective study of 110 critical care patients in shock status. Arterial and venous blood gases were obtained simultaneously to calculate DvaCO₂/DavO₂. Multivariate analysis was conducted to predict mortality and lactate clearance. Additionally, ROC curves were built comparing intrahospitalary mortality with those variables. Results: Intrahospitalary mortality was 35%. Variables with statistically minor values in survivors were lactate upon ICU admission and DvaCO₂/DavO₂ at 48 hours. At 48 hours, the ability of DvaCO₂/DavO₂ to predict mortality has AUC = 0.81 (0.72-0.90). DvaCO₂/DavO₂ seems to be a good marker to discriminate lactate › 4 mmol/L at 48 hours, with AUC = 0.79 (0.71-0.88). Conclusions: DvaCO₂/DavO₂ persistently high at 48 hours is a good predictor of intrahospitalary mortality and persistent hyperlactatemia.

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