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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versão impressa ISSN 2448-8909
Resumo
LEON MONTIEL, Irán Emmanuel; MENDOZA RODRIGUEZ, Martín; CORTES MUNGUIA, José Alfredo e LOPEZ GONZALEZ, Alfonso. CO2 delta as a strategy for the comprehensive management of patients with septic shock in the ICU. Med. crít. (Col. Mex. Med. Crít.) [online]. 2023, vol.37, n.1, pp.9-16. Epub 30-Set-2023. ISSN 2448-8909. https://doi.org/10.35366/109956.
Introduction:
septic shock is a subset of sepsis in which underlying circulatory, cellular, and metabolic abnormalities are profound enough to substantially increase mortality. These patients can be identified in a clinical setting of septic shock with persistent hypotension. The importance of monitoring delta pCO2 values of 6 mmHg serves as a complementary tool to assess adequate blood flow towards global metabolic demand.
Objective:
to demonstrate that the pCO2 delta is useful in the comprehensive management of patients with septic shock in the Intensive Care Unit to direct the treatment according to this biomarker (pCO2 delta) that was recorded at admission and at 24 hours, were related to prognosis and mortality in septic shock.
Material and methods:
descriptive, ambispective, longitudinal and analytical study. The universe was made up of patients admitted to the ICU of the La Villa and Rubén Leñero General Hospitals. Maneuver design: arterial and venous blood gases were taken from the patients admitted to the ICU, the pCO2 delta was calculated to see if the values of this biomarker were above or below 6 mmHg, since a pCO2 delta is related to with mortality; however, delta pCO2 was compared against Lactate to correlate lactate levels greater than two with mortality and finally see which of the two biomarkers is more useful. Descriptive statistics were used for the results.
Conclusion:
according to the results found in this study, it can be said that delta pCO2 and lactate predicted the death of 15%, which has a weak positive significance (p = 0.245).
Palavras-chave : arterial blood gases; morbidity; mortality; intensive care unit; septic shock; pCO2 delta.