Mendoza PE, Lozano NJJ, Mendoza RM

Language: Spanish
References: 7
Page: 16-19
PDF size: 152.97 Kb.

ABSTRACT

Background: Hemorrhagic shock leads to decrease in oxygen supply, decreased tissue perfusion, cellular hypoxia, cell damage, multiple organ dysfunction syndrome and death. It is shown that there are different prognostic scales and biochemical determinations that identify the patient at risk.
Aim: To establish the correlation between the Briones index, ΔCO₂ and organ dysfunction in patients with traumatic hypovolemic shock.
Material and methods: A transversal, retrospective, comparative and analytical study; from January 2015 to May 2016, involving 46 patients diagnosed with traumatic hypovolemic shock who were admitted to the intensive care unit of the General Hospital La Villa. We evaluated demographic variables, oncotic presion, Briones index, arteriovenous difference of CO₂. We prognostic and monitoring 48 hours with descenlace points: mortality and organic dysfunction.
Results: Of the 46 study participants represented gender: female 41%, men 59%. The average age: 38 ± 14.6 years. Hypovolemic shock classification based deficit represented: class I: 7%, class II: 39%, class III: 11 24%, class IV: 30%; IB: 0.25 ± 0.07 mmHg, DB: -7.9 ± 5.2 mmol/L, lactate: 3.01 ± 2.2 mmol/L, ΔCO₂: 6.98 ± 4.6 mmHg. Mortality at 48 hours: was 10.8%. Trauma score 9 ± 3 points; SOFA: 6 ± 3 points. Acute kidney injury (AKI) occurred in 41%. ΔCO₂ › 6 mmHg showed sensitivity 0.91 and specificity 0.54 as a predictor of mortality, the highest cutpoint 10.5 mmHg was identified with 0.96 and 0.98 respectively (p ‹ 0.001, confidence interval IC 0.988-1.0; area under the curve AUC 0.998).
Conclusions: This study showed that ΔCO₂ is a marker with impact on mortality and prognostic scales and Trauma SOFA score. The IB can be used as a prognostic in patients who developed Acute kidney injury (AKI) within the first 48 hours of stay in the ICU with adequate statistical significance.

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