الفهرس | Only 14 pages are availabe for public view |
Abstract Sepsis is a life-threatening condition that arises when the body’s response to infection injures its own tissues and organs. Sepsis causes millions of deaths globally each year and is the most common cause of death in people who have been hospitalized. Despite significant advances in understanding the pathophysiology of sepsis, mortality from the disease remains unacceptably high. Management of sepsis is largely supportive, which was given a huge importance to study factors that could predict outcome in patients suffering from sepsis and early recognition of signs of tissue hypoperfusion and their value during resuscitation. The way to assess tissue perfusion during the resuscitation of septic patients is a current subject of research and debate. Venous oxygen saturation and lactate concentration have been the most frequently used criteria, though they involve known limitations. The venous-to-arterial difference of carbon dioxide (P (cv-a) CO2) is a parameter that can be used to indicate tissue perfusion, and its determination therefore may be useful in these patients. Our study was conducted over 40 septic patients who met the inclusion criteria, on admission P (cv-a) CO2 gap was calculated and patients were classified according to P(cv-a)CO2 into high gap patients (>6mmHg) and low gap patients (<6mmHg), patients have been observed for lactate clearance over 12 hours, SOFA score after 24 hour and after 15 days and mortality if occurred within 28 day from ICU admission. The result of the study showed that the high P(cv-a)Co2 (> 6 mmHg) in ICU patients suffering from sepsis may have a prognostic value, those patients morbidity was higher and their SOFA score was worsen (P = 0.016 ), and had slower lactate clearance (P = 0.032), however their ICU length of stay (P=0.291) and 28-day mortality (p = 0.058) were not significantly different when compared to patients presented with P(cv-a) Co2 (<6 mmHg). Future studies have to be conducted over P(cv-a)Co2 with higher cut off value and to classify patients according to their comorbidities. |