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Intensive Care Medicine

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01-06-2013 | Original

Central venous-arterial pCO₂ difference as a tool in resuscitation of septic patients

Authors: Paul A. van Beest, Mariska C. Lont, Nicole D. Holman, Bert Loef, Michaël A. Kuiper, E. Christiaan Boerma

Published in: Intensive Care Medicine | Issue 6/2013

Abstract

Purpose

To investigate the interchangeability of mixed and central venous-arterial carbon dioxide differences and the relation between the central difference (pCO₂ gap) and cardiac index (CI). We also investigated the value of the pCO₂ gap in outcome prediction.

Methods

We performed a post hoc analysis of a well-defined population of 53 patients with severe sepsis or septic shock. Mixed and central venous pCO₂ were determined earlier at a 6 h interval (T = 0 to T = 4) during the first 24 h after intensive care unit (ICU) admittance. The population was divided into two groups based on pCO₂ gap (cut off value 0.8 kPa).

Results

The mixed pCO₂ difference underestimated the central pCO₂ difference by a mean bias of 0.03± 0.32 kPa (95 % limits of agreement: −0.62–0.58 kPa). We observed a weak relation between pCO₂ gap and CI. The in hospital mortality rate was 21 % (6/29) for the low gap group and 29 % (7/24) for the high gap group; the odds ratio was 1.6 (95 % CI 0.5–5.5), p = 0.53. At T = 4 the odds ratio was 5.3 (95 % CI 0.9–30.7); p = 0.08.

Conclusions

From a practical perspective, the clinical utility of central venous pCO₂ values is of potential interest in determining the venous-arterial pCO₂ difference. The likelihood of a bad outcome seems to be enhanced when a high pCO₂ gap persists after 24 h of therapy.

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Title: Central venous-arterial pCO2 difference as a tool in resuscitation of septic patients
Authors: Paul A. van Beest
Mariska C. Lont
Nicole D. Holman
Bert Loef
Michaël A. Kuiper
E. Christiaan Boerma
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 6/2013
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-013-2888-x

2024 ASCO Annual Meeting

Springer Medicine

Central venous-arterial pCO₂ difference as a tool in resuscitation of septic patients

Abstract

Purpose

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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