2018, Number 4
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ABSTRACTIntroduction: 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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