Monitoreo de la perfusión tisular en pacientes con shock septico.

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Published: Jun 17, 2020
Keywords:
Tissue perfusion, Venous saturation, Carbon dioxide coefficient, Sepsis, Shock

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Daniel Alejandro Duarte
CLINICA DE ESPECIALIDADES MEDICAS PRIVADA (CEMEP)
Romina Vanesa Nicastro
CEMEP
Gustavo Benavent
CEMEP
Ana Monson
CEMEP
Jorge Roldan
CEMEP
Yanina Escobar
CEMEP
Nestor Raimondi
CEMEP
Fabian Plano

Abstract

Objective. Determine the central venous oxygen saturation (SvcO2), the venoarterial difference of carbon dioxide (Delta P (av) CO2) and the arteriovenous oxygen content (Delta P (av) CO2 / C (av) O2) upon entry into the first 24 hours of septic shock, to predict mortality.


Adults who entered the multipurpose STI with a diagnosis of septic shock (SS) from the period between March 2016 and March 2017.


Results: 4 groups of patients in the first 24 hours after admission according to SvcO2 values. Group 1: SvcO2>70%, DeltaP(a-v)CO2/C(a-v)O2<1.4; Group 2: SvcO2>70%, DeltaP(av)CO2/C(av)O2>1.4; Group 3: SvcO2<70%, DeltaP(av)CO2/C(av)O2<1.4 and Group 4: SvcO2<70%, DeltaP(av)CO2/C(av)O2>1.4. 80 patients who entered the STI with SS were evaluated; 4 p who died within 24 hours of admission were excluded, the average age 53 +/- 16 years, the mean SAPS II 63. the most prevalent infectious focus was 35% pulmonary. The days of mechanical ventilation were 12 days (3-21), the mean stay in the STI was 14 (4-23), they required 16% renal replacement, the overall mortality was 36.8%. In the bivariate analysis of it was observed between the group S and NS in the variables DP (av) CO2 4 (3-5) versus 6.5 (4-9) p = 0.025 lactate> 2 (43%) versus (93%) p = 0.003, SvcO2 <70% (21.7%) versus (50%) p = 0.005 and Delta P (av) CO2 / C (av)> 1.4 (43%) versus (79%) p = 0.04 respectively. The rest of the variables did not show significant differences.


Conclusion: SS patients who have SvcO2<70% and DeltaP(a-v)CO2/C (a-v)>1.4 measured in the 24 hours of admission have higher mortality at 30 days.

Article Details

How to Cite
1.
Duarte DA, Nicastro RV, Benavent G, Monson A, Roldan J, Escobar Y, et al. Monitoreo de la perfusión tisular en pacientes con shock septico. Rev Arg de Ter Int. [Internet]. 2020 Jun. 17 [cited 2024 Nov. 22];37(2). Available from: https://revista.sati.org.ar/index.php/MI/article/view/567
Issue
Vol. 37 No. 2 (2020): Revista Argentina de Terapia Intensiva
Section
Originales

The magazine does not retain the reproduction rights (copyright) so the authors can republish their works with the sole mention of the original publication source.

Author Biography

Daniel Alejandro Duarte, CLINICA DE ESPECIALIDADES MEDICAS PRIVADA (CEMEP)

JEFE DE DEPARTAMENTO DE CUIDADOS INTENSIVOS

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