The Evolution of Central Venous-to-arterial Carbon Dioxide Difference (PCO 2 Gap) during Resuscitation Affects ICU Outcomes: A Prospective Observational Study.

Autor: Zirpe KG; Neurotrauma Intensive Care Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Tiwari AM; Neurotrauma Intensive Care Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Kulkarni AP; Department of Anaesthesia and Critical Care, Tata Memorial Hospital, Mumbai, Maharashtra, India., Vaidya HS; Neurotrauma Intensive Care Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Gurav SK; Neurotrauma Intensive Care Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Deshmukh AM; Neurotrauma Intensive Care Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Suryawanshi PB; Neurotrauma Intensive Care Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Kapse US; Neurotrauma Intensive Care Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Bhoyar AP; Neurotrauma Intensive Care Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Dhawad PA; Neurotrauma Intensive Care Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Mukherjee S; Neurotrauma Intensive Care Unit, Ruby Hall Clinic, Pune, Maharashtra, India.
Jazyk: angličtina
Zdroj: Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine [Indian J Crit Care Med] 2024 Apr; Vol. 28 (4), pp. 349-354.
DOI: 10.5005/jp-journals-10071-24680
Abstrakt: Introduction: The usual methods of perfusion assessment in patients with shock, such as capillary refill time, skin mottling, and serial serum lactate measurements have many limitations. Veno-arterial difference in the partial pressure of carbon dioxide (PCO 2 gap) is advocated being more reliable. We evaluated serial change in PCO 2 gap during resuscitation in circulatory shock and its effect on ICU outcomes.
Materials and Methods: This prospective observational study included 110 adults with circulatory shock. Patients were resuscitated as per current standards of care. We recorded invasive arterial pressure, urine output, cardiac index (CI), PCO 2 gap at ICU admission at 6, 12, and 24 hours, and various patient outcomes.
Results: Significant decrease in PCO 2 gap was observed at 6 h and was accompanied by improvement in serum lactate, mean arterial pressure, CI and urine output in ( n = 61). We compared these patients with those in whom this decrease did not occur ( n = 49). Mortality and ICU LOS was significantly lower in patients with low PCO 2 gap, while more patients with high PCO 2 gap required RRT.
Conclusion: We found that a persistently high PCO 2 gap at 6 and 12 h following resuscitation in patients with shock of various etiologies, was associated with increased mortality, need for RRT and increased ICU LOS. High PCO 2 gap had a moderate discriminative ability to predict mortality.
How to Cite This Article: Zirpe KG, Tiwari AM, Kulkarni AP, Vaidya HS, Gurav SK, Deshmukh AM, et al . The Evolution of Central Venous-to-arterial Carbon Dioxide Difference (PCO 2 Gap) during Resuscitation Affects ICU Outcomes: A Prospective Observational Study. Indian J Crit Care Med 2024;28(4):349-354.
Competing Interests: Source of support: Nil Conflict of interest: Dr. Kapil G Zirpe and Dr. Atul P Kulkarni are associated as the Editorial Board Member of this journal and this manuscript was subjected to this journal's standard review procedures, with this peer review handled independently of these Editorial Board Members and their research group.
(Copyright © 2024; The Author(s).)
Databáze: MEDLINE
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