Higher AVCO2 and Lactate Gradient Combined with SOFA Score as a Mortality Predictor during the 6-Hours of Resuscitation of Septic Shock

Background: Sepsis is a severe and life-threatening condition leading to widespread inflammation and organ dysfunction. It is a medical emergency that requires immediate attention and treatment. One of the key indicators used to assess the severity and prognosis of sepsis is lactate level. Another...

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Main Authors: Morteza Talebi Doluee, Sahar Azam Ghasemzadeh, Ahmad Bagheri Moghadam, Zahra Abbasishaye, Davood Soroosh, Elnaz Vafadar Moradi
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2024-10-01
Series:Archives of Anesthesia and Critical Care
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Online Access:https://aacc.tums.ac.ir/index.php/aacc/article/view/1029
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author Morteza Talebi Doluee
Sahar Azam Ghasemzadeh
Ahmad Bagheri Moghadam
Zahra Abbasishaye
Davood Soroosh
Elnaz Vafadar Moradi
author_facet Morteza Talebi Doluee
Sahar Azam Ghasemzadeh
Ahmad Bagheri Moghadam
Zahra Abbasishaye
Davood Soroosh
Elnaz Vafadar Moradi
author_sort Morteza Talebi Doluee
collection DOAJ
description Background: Sepsis is a severe and life-threatening condition leading to widespread inflammation and organ dysfunction. It is a medical emergency that requires immediate attention and treatment. One of the key indicators used to assess the severity and prognosis of sepsis is lactate level. Another key indicator of sepsis severity is a significant difference in the level of carbon dioxide (CO2) between veins and arteries. Methods: In this study, we aimed to evaluate the differences in the venous and arterial PCO2 and lactate levels during the first 6 hours of treatment of septic shock. In this prospective observational-analytical study patients with septic shock admitted to the ICU were evaluated. Sepsis is defined as patients who had 1 or more of the SIRS criteria with a possible or proven source of infection and hypotension despite appropriate fluid therapy who needed to receive vasopressors. Results: Among 85 patients the mean age was 64±17 years and 48 (56%) were men. Of these patients, 15 (17%) died, of them 8 (53.33%) were male, 14 (93%) were diabetic, 11(73.33%) were hypertensive, 11 (73.33%) had ischemic Heart disease and 9 (60%) patients had Chronic Obstructive Pulmonary Disease (COPD). The mean HR, SBP, and DBP were significantly higher in lived patients; the SOFA scores were significantly lower in these patients. Conclusion: Overall, the gradient of AV PCO2 and lactate clearance combined with SOFA score can be a valuable tool for clinicians in predicting mortality risk in critically ill patients and guiding treatment decisions.
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spelling doaj-art-dc45517a66a541cb88d0a2075ae3acc62025-02-09T08:53:26ZengTehran University of Medical SciencesArchives of Anesthesia and Critical Care2423-58492024-10-0111110.18502/aacc.v11i1.17495Higher AVCO2 and Lactate Gradient Combined with SOFA Score as a Mortality Predictor during the 6-Hours of Resuscitation of Septic ShockMorteza Talebi Doluee0Sahar Azam Ghasemzadeh1Ahmad Bagheri Moghadam2Zahra Abbasishaye3Davood Soroosh4Elnaz Vafadar Moradi5Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Department of Anesthesiology and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Department of Forensic Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Background: Sepsis is a severe and life-threatening condition leading to widespread inflammation and organ dysfunction. It is a medical emergency that requires immediate attention and treatment. One of the key indicators used to assess the severity and prognosis of sepsis is lactate level. Another key indicator of sepsis severity is a significant difference in the level of carbon dioxide (CO2) between veins and arteries. Methods: In this study, we aimed to evaluate the differences in the venous and arterial PCO2 and lactate levels during the first 6 hours of treatment of septic shock. In this prospective observational-analytical study patients with septic shock admitted to the ICU were evaluated. Sepsis is defined as patients who had 1 or more of the SIRS criteria with a possible or proven source of infection and hypotension despite appropriate fluid therapy who needed to receive vasopressors. Results: Among 85 patients the mean age was 64±17 years and 48 (56%) were men. Of these patients, 15 (17%) died, of them 8 (53.33%) were male, 14 (93%) were diabetic, 11(73.33%) were hypertensive, 11 (73.33%) had ischemic Heart disease and 9 (60%) patients had Chronic Obstructive Pulmonary Disease (COPD). The mean HR, SBP, and DBP were significantly higher in lived patients; the SOFA scores were significantly lower in these patients. Conclusion: Overall, the gradient of AV PCO2 and lactate clearance combined with SOFA score can be a valuable tool for clinicians in predicting mortality risk in critically ill patients and guiding treatment decisions. https://aacc.tums.ac.ir/index.php/aacc/article/view/1029SepsisLactatePrognosisIntensive Care Unite
spellingShingle Morteza Talebi Doluee
Sahar Azam Ghasemzadeh
Ahmad Bagheri Moghadam
Zahra Abbasishaye
Davood Soroosh
Elnaz Vafadar Moradi
Higher AVCO2 and Lactate Gradient Combined with SOFA Score as a Mortality Predictor during the 6-Hours of Resuscitation of Septic Shock
Archives of Anesthesia and Critical Care
Sepsis
Lactate
Prognosis
Intensive Care Unite
title Higher AVCO2 and Lactate Gradient Combined with SOFA Score as a Mortality Predictor during the 6-Hours of Resuscitation of Septic Shock
title_full Higher AVCO2 and Lactate Gradient Combined with SOFA Score as a Mortality Predictor during the 6-Hours of Resuscitation of Septic Shock
title_fullStr Higher AVCO2 and Lactate Gradient Combined with SOFA Score as a Mortality Predictor during the 6-Hours of Resuscitation of Septic Shock
title_full_unstemmed Higher AVCO2 and Lactate Gradient Combined with SOFA Score as a Mortality Predictor during the 6-Hours of Resuscitation of Septic Shock
title_short Higher AVCO2 and Lactate Gradient Combined with SOFA Score as a Mortality Predictor during the 6-Hours of Resuscitation of Septic Shock
title_sort higher avco2 and lactate gradient combined with sofa score as a mortality predictor during the 6 hours of resuscitation of septic shock
topic Sepsis
Lactate
Prognosis
Intensive Care Unite
url https://aacc.tums.ac.ir/index.php/aacc/article/view/1029
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