Lont M.C. (2012) De betekenis van de CO2 gap bij sepsispatiënten opgenomen op de intensive care unit. thesis, Medicine.
Full text available on request.Abstract
Introduction: The aim of this research was getting knowledge about the meaning of the CO2-gap in patients, admitted to the intensive care unit (ICU) with severe sepsis or septic shock. CO2-gap is the pCO2 difference between arterial and mixed/central venous blood. Methods: This post-hoc analysis was performed on data of a prospective observational study. Arterial, central venous and mixed venous blood samples were collected from 54 patients during the first 24 hours after admission to the ICU in 2 Dutch hospitals. We assessed the agreement between the central venous CO2¬-gap (P(cv-a)CO2¬) and the mixed venous CO2-gap (P(v-a)CO2), the correlation between cardiac index (CI) and CO2-gap and the relation between CO2-gap>0.8kPa and hospital mortality. All test were performed at 0, 12 and 24 hours after admission to the ICU. Results: A total of 265 paired blood samples were obtained. There was no agreement between P(cv-a)CO2 and P(v-a)CO2 at any time point. CI and CO2-gap correlate significantly by admission to ICU but this relation was clinically irrelevant (p=0.01; R2=0,124). CO2-gap>0.8kPa after 24 hours stay at ICU was strongly related to hospital mortality (P=0.008; Odds ratio=30) Conclusions: We concluded that P(cv-a)CO2 does not reliably predict P(v-a)CO2, so both are not comparable. Only a small share of CO2-gap is determined by cardiac index in septic patients. CO2-gap>0.8kPa, 24 hours after admission to the ICU, gives a 30 times higher probability of dying during hospital stay in comparison to a CO2-gap≤0.8kPa.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Boerma, E.C. MD and Afdeling Intensive Care and Medisch Centrum Leeuwarden |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:41 |
| Last Modified: | 25 Jun 2020 10:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/230 |
Actions (login required)
 |
View Item |