Dados do Trabalho

Título

The Venous-Arterial CO2 to Arterial-Venous O2 Ratio as a predictor of mortality in septic patients without shock admitted to Intensive Care Units

Objetivo

To verify if the Venous-Arterial CO2 to Arterial-Venous O2 Ratio (Cv-aCO2/Ca-vO2 Ratio) measured at Intensive Care Unit (ICU) admission is associated with mortality prediction in septic patients, without shock.

Métodos

Prospective, multicentric cohort which took place in two tertiary hospitals, one in Brazil and the other in Italy. We included adult patients with a sepsis diagnosis according to Sepsis-3 criteria. Demographic and laboratory data were collected. SAPS 3 score was calculated using data from the first day of hospital care. Patients were followed up until hospital discharge or death. The Cv-aCO2/Ca-vO2 ratio was calculated using variables from arterial and central venous blood gases. Statistical analysis was carried out using descriptive statistics with categorical variables being reported as counts and percentages, and continuous variables as means with standard deviations or medians with interquartile ranges. A multivariate model was constructed to identify variables independently associated with in-hospital mortality.

Resultados

81 septic patients without shock were included. The median age was 75.0 (62.0 – 84.0) years, with a predominance of males (n = 43; 53.1%). The mean SAPS 3 score was 53.0 ± 12.6. The main site of infection was pulmonary (n = 35; 43.2%). The mean Cv-aCO2/Ca-vO2 Ratio was 1,67 (IQR 1,26-2,61). The mean Venous-Arterial CO2 to Arterial-Venous O2 Ratio was higher in non-survivors x survivors, respectively, 2.18 (IQR 1.56-3.01) x 1.46 (IQR 0.89-1.84), p<0.001.

Conclusão

The Venous-Arterial CO2 to Arterial-Venous O2 Ratio showed to be a good discriminatory predictor of mortality outcomes in septic patients without shock admitted to ICU.