Venous-arterial CO2 difference in children with sepsis and its correlation with myocardial dysfunction
Objective: This study aimed to determine the association between venous-arterial CO2 difference (Pv-aCO2) and clinical outcomes of interest in children with severe sepsis and septic shock. Design: An analytical observational study of a prospective cohort was conducted. Setting: The study was carried...
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Hamad Medical Corporation
2019
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ir-10336-229122022-05-02T12:37:14Z Venous-arterial CO2 difference in children with sepsis and its correlation with myocardial dysfunction Fernández-Sarmiento, Jaime Carcillo, Joseph A Díaz Del Castillo, Ana Maria Eraso Barrera, Pedro Orozco, Rafael Rodríguez, María Angélica Gualdrón, Nathalie Carbon dioxide Lactic acid Steroid Adolescent Adrenal insufficiency Analytical research Arterial carbon dioxide tension Article Child Clinical outcome Cohort analysis Continuous infusion Female Human Lactate blood level Lung infection Major clinical study Male Multiple organ failure Myocardial disease Observational study Prospective study Septic shock Steroid therapy Survival rate Tissue perfusion Transthoracic echocardiography Venous oxygen tension Children Mortality Myocardial dysfunction Pv-aco2 Sepsis Septic shock Venous saturation Objective: This study aimed to determine the association between venous-arterial CO2 difference (Pv-aCO2) and clinical outcomes of interest in children with severe sepsis and septic shock. Design: An analytical observational study of a prospective cohort was conducted. Setting: The study was carried out from January 2015 to January 2018 in the pediatric intensive care unit of a referral hospital. Materials and methods: 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-aCO2, and other measures of tissue perfusion such as arterial lactate, venous, and evolution to multiple organ failure. Measurements and main results: 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, p = 0.02). However, there was no correlation between myocardial dysfunction seen on echocardiogram and a Pv-aCO2 greater than 6 mm Hg in children with severe sepsis and septic shock (r = 0.13). Pv-aCO2 and central venous saturation had low sensitivity to detect multiple organ failure and poor correlation with the number of compromised systems (r = 0.8). Conclusion: Pv-aCO2 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. © 2019 Fernández-Sarmiento, Carcillo, Eraso-Díaz del Castillo, Barrera, Orozco, Rodríguez, Gualdrón, licensee HBKU Press. 2019 2020-05-25T23:58:41Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 2538253 https://repository.urosario.edu.co/handle/10336/22912 https://doi.org/10.5339/qmj.2019.18 eng info:eu-repo/semantics/openAccess application/pdf Hamad Medical Corporation instname:Universidad del Rosario |
institution |
EdocUR - Universidad del Rosario |
collection |
DSpace |
language |
Inglés (English) |
topic |
Carbon dioxide Lactic acid Steroid Adolescent Adrenal insufficiency Analytical research Arterial carbon dioxide tension Article Child Clinical outcome Cohort analysis Continuous infusion Female Human Lactate blood level Lung infection Major clinical study Male Multiple organ failure Myocardial disease Observational study Prospective study Septic shock Steroid therapy Survival rate Tissue perfusion Transthoracic echocardiography Venous oxygen tension Children Mortality Myocardial dysfunction Pv-aco2 Sepsis Septic shock Venous saturation |
spellingShingle |
Carbon dioxide Lactic acid Steroid Adolescent Adrenal insufficiency Analytical research Arterial carbon dioxide tension Article Child Clinical outcome Cohort analysis Continuous infusion Female Human Lactate blood level Lung infection Major clinical study Male Multiple organ failure Myocardial disease Observational study Prospective study Septic shock Steroid therapy Survival rate Tissue perfusion Transthoracic echocardiography Venous oxygen tension Children Mortality Myocardial dysfunction Pv-aco2 Sepsis Septic shock Venous saturation Fernández-Sarmiento, Jaime Carcillo, Joseph A Díaz Del Castillo, Ana Maria Eraso Barrera, Pedro Orozco, Rafael Rodríguez, María Angélica Gualdrón, Nathalie Venous-arterial CO2 difference in children with sepsis and its correlation with myocardial dysfunction |
description |
Objective: This study aimed to determine the association between venous-arterial CO2 difference (Pv-aCO2) and clinical outcomes of interest in children with severe sepsis and septic shock. Design: An analytical observational study of a prospective cohort was conducted. Setting: The study was carried out from January 2015 to January 2018 in the pediatric intensive care unit of a referral hospital. Materials and methods: 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-aCO2, and other measures of tissue perfusion such as arterial lactate, venous, and evolution to multiple organ failure. Measurements and main results: 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, p = 0.02). However, there was no correlation between myocardial dysfunction seen on echocardiogram and a Pv-aCO2 greater than 6 mm Hg in children with severe sepsis and septic shock (r = 0.13). Pv-aCO2 and central venous saturation had low sensitivity to detect multiple organ failure and poor correlation with the number of compromised systems (r = 0.8). Conclusion: Pv-aCO2 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. © 2019 Fernández-Sarmiento, Carcillo, Eraso-Díaz del Castillo, Barrera, Orozco, Rodríguez, Gualdrón, licensee HBKU Press. |
format |
Artículo (Article) |
author |
Fernández-Sarmiento, Jaime Carcillo, Joseph A Díaz Del Castillo, Ana Maria Eraso Barrera, Pedro Orozco, Rafael Rodríguez, María Angélica Gualdrón, Nathalie |
author_facet |
Fernández-Sarmiento, Jaime Carcillo, Joseph A Díaz Del Castillo, Ana Maria Eraso Barrera, Pedro Orozco, Rafael Rodríguez, María Angélica Gualdrón, Nathalie |
author_sort |
Fernández-Sarmiento, Jaime |
title |
Venous-arterial CO2 difference in children with sepsis and its correlation with myocardial dysfunction |
title_short |
Venous-arterial CO2 difference in children with sepsis and its correlation with myocardial dysfunction |
title_full |
Venous-arterial CO2 difference in children with sepsis and its correlation with myocardial dysfunction |
title_fullStr |
Venous-arterial CO2 difference in children with sepsis and its correlation with myocardial dysfunction |
title_full_unstemmed |
Venous-arterial CO2 difference in children with sepsis and its correlation with myocardial dysfunction |
title_sort |
venous-arterial co2 difference in children with sepsis and its correlation with myocardial dysfunction |
publisher |
Hamad Medical Corporation |
publishDate |
2019 |
url |
https://repository.urosario.edu.co/handle/10336/22912 https://doi.org/10.5339/qmj.2019.18 |
_version_ |
1740172866589032448 |
score |
12,131701 |