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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versión impresa ISSN 2448-8909
Resumen
SANCHEZ NAVA, Víctor Manuel; MUNOZ RAMIREZ, María del Rosario; CHAVEZ PEREZ, Carlos y GUERRERO IZAGUIRRE, Israel. Usefulness of gasometric parameters as predictors of mortality in septic shock patients. Med. crít. (Col. Mex. Med. Crít.) [online]. 2017, vol.31, n.3, pp.128-135. ISSN 2448-8909.
Objectives:
To describe the carbon dioxide parameters, base deficit and central venous saturation in septic shock patients and observe if the change between the initial value (T0) and at 24 hours (T1) influences their prognosis.
Material and methods:
We performed a retrospective and observational study from March 2014 to July 2016. We included patients at least 18 years old with septic shock diagnosis. We assessed SOFA and APACHE II at admission and the derived gasometric parameters at diagnosis of septic shock and at 24 hours of treatment.
Results:
We included 39 patients. Survivors (n = 25) and non-survivors (n = 14). Upon admission (T0) there were differences between both groups in ΔPCO2 and ΔPCO2/Ca-vO2 (7.2 ± 2.4 versus 8.7 ± 2.0 mmHg, p = 0.05) and (1.7 ± 0.5 versus 2.1 ± 0.9 mmHg/mL, p = 0.05), respectively. At 24 hours (T1) base deficit (BD) and mean arterial pressure (MAP) showed significant differences (-4.5 ± 5.0 versus -9.5 ± 7.7 mEq/L, p = 0.02) and (81 ± 10 versus 70 ± 9 mmHg, p = 0.03). The change in BD (ΔBD) between (T0) and (T1) was significant (-4.5 ± 4.1 versus 2.1 ± 6.3 mEq/L, p = 0.001) and ΔPCO2/Ca-vO2 ratio (ΔRatio) showed no difference (-0.02 ± 1.2 versus 0.72 ± 1.7 mmHg/mL, p = 0.13) among the groups.
Conclusions:
Beside ΔPCO2 and ΔPCO2/Ca-vO2 ratio, base deficit can be a prognostic instrument in patients with septic shock.
Palabras llave : Septic shock; ΔPCO2; ΔPCO2/Ca-vO2; base deficit.