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Medicina crítica (Colegio Mexicano de Medicina Crítica)
Print version ISSN 2448-8909
Abstract
CARBALLO MOLINA, Laura et al. The anaerobiosis index predicts mortality in patients with severe pneumonia due to SARS-CoV-2. Med. crít. (Col. Mex. Med. Crít.) [online]. 2022, vol.36, n.1, pp.9-13. Epub Oct 28, 2022. ISSN 2448-8909. https://doi.org/10.35366/104470.
Introduction:
Detecting and correcting anaerobic metabolism is essential in the critically ill patient, unfortunately, there is no gold standard. Patients with severe pneumonia due to SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) present severe hypoxemia, increasing anaerobic metabolism. Lactate and the venoarterial carbon dioxide pressure difference/arteriovenous oxygen content difference (Δp(v-a)CO2/ΔC(a-v)O2) are useful in this context.
Material and methods:
Prospective, descriptive and analytical cohort study that included patients admitted to the Intensive Care Unit (ICU) in the period from April 18, 2020 to January 18, 2021 with severe pneumonia (defined by the start of invasive mechanical ventilation) by SARS-CoV-2 confirmed.
Results:
In the period covered, 91 patients who met the inclusion criteria were included. Of the total, 39 patients were included in the survivors group and 52 in the non-survivors group. It can be seen that the Δp(v-a)CO2/ΔC(a-v)O2 also called anaerobiosis index has OR 4.4, 95% CI 1.51-13.04, p = 0.006 in the multivariate analysis.
Conclusion:
The increase in the Δp(v-a)CO2/ΔC(a-v)O2 also called anaerobiosis index > 1.4 mmHg/mL is associated with a 4.44 times higher risk of death in patients with severe pneumonia (intubated) due to SARS-CoV-2.
Keywords : Anaerobic metabolism; severe pneumonia; anaerobiosis index.