Trejo AA, Martínez ZR, Cerón DUW, Sagardia SL

Language: Spanish
References: 13
Page: 119-126
PDF size: 230.48 Kb.

ABSTRACT

Objective: To compare the adverse outcomes in the same patient population in different states of shock evaluated by two parameters of anaerobic metabolism within the cutoff value of lactate ≤ 2 y › 2 mmol/L and the ΔPCO₂/Ca-vO₂ ratio ≤ 1.4 and › 1.4.
Methods: Prospective observational study from February to July 2015 in patients with a state of shock, older than eighteen years of age, at the intensive care unit (ICU). Arterial and venous blood gas samples were taken twice. The markers studied were measured, as well as SOFA upon patient’s admission and 24 hours later, fluid balance at six hours, total time in hours of invasive mechanical ventilation and of ICU stay. The state of health of patients was investigated at 28 days.
Results: Twenty-six patients were included. Thirteen patients were diagnosed with septic shock, nine with hypovolemic shock, three with cardiogenic shock and one with mixed shock. The overall mortality was of 65% (n = 17) in 28 days. A ΔPCO₂/Ca-vO₂ ratio › 1.4 was associated with a significantly greater mortality (82%) compared with patients who had a ratio ≤ 1.4 (33%) p = 0.012. SOFA at 24 hours in the ΔPCO₂/Ca-vO₂ ≤ 1.4 group was 6.6 ± 3, and 11 ± 5 in the › 1.4 (p = 0.04) group. There was no statistically significant difference in the evaluation with lactate or any association with mortality.
Conclusion: In this study ΔPCO₂/Ca-vO₂ ratio seems to be a reliable parameter of tissue hypoperfusion in patients in shock, with greater sensitivity and specificity in predicting mortality at 28 days.

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