Venous-arterial CO 2 difference in children with sepsis and its correlation with myocardial dysfunction

This study aimed to determine the association between venous-arterial CO difference (Pv-aCO ) and clinical outcomes of interest in children with severe sepsis and septic shock. An analytical observational study of a prospective cohort was conducted. The study was carried out from January 2015 to Jan...

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Published inQatar medical journal Vol. 2019; no. 3; p. 18
Main Authors Fernández-Sarmiento, Jaime, Carcillo, Joseph A, Díaz Del Castillo, Ana Maria Eraso, Barrera, Pedro, Orozco, Rafael, Rodríguez, María Angélica, Gualdrón, Nathalie
Format Journal Article
LanguageEnglish
Published Qatar 2019
Subjects
septic shock
children
venous saturation
mortality
myocardial dysfunction
Pv-aCO2
sepsis
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Summary:This study aimed to determine the association between venous-arterial CO difference (Pv-aCO ) and clinical outcomes of interest in children with severe sepsis and septic shock. An analytical observational study of a prospective cohort was conducted. The study was carried out from January 2015 to January 2018 in the pediatric intensive care unit of a referral hospital. Of a total of 1159 patients who were admitted to pediatric critical care, 375 had severe sepsis and septic shock, of which 67 fulfilled the inclusion criteria. Arterial and venous gases were drawn simultaneously with a transthoracic echocardiogram, Pv-aCO , and other measures of tissue perfusion such as arterial lactate, venous, and evolution to multiple organ failure. Half (53.7%) of the patients were under 24 months old, with a slight predominance of male patients. The main site of infection was the lungs in 56% of the cases, with a 91.2% survival rate. Patients who died had a higher venous lactate level (interquartile range 16.2-33.6,  = 0.02). However, there was no correlation between myocardial dysfunction seen on echocardiogram and a Pv-aCO greater than 6 mm Hg in children with severe sepsis and septic shock (  = 0.13). Pv-aCO and central venous saturation had low sensitivity to detect multiple organ failure and poor correlation with the number of compromised systems (  = 0.8). Pv-aCO was not associated with myocardial dysfunction, measured by echocardiogram, in children with severe sepsis and septic shock. It also did not correlate with the number of organs involved or mortality.
ISSN:0253-8253