Sarcouncil Journal of Medical Sciences

Abstract: Background: In the treatment of critically ill patients, the detection of tissue hypoxia and hypoperfusion is crucial. Serum lactate and central venous oxygen saturation (ScvO2) are examples of global indicators of tissue perfusion. Despite the fact that the venous-arterial PCO2 difference (ΔPCO2) cannot be used as a measure of tissue hypoxia, it is thought to be a sign of adequate venous blood flow (Cardiac output) to remove the total CO2 produced by the peripheral tissues. The Aim of the Current Study: was to assess how the venous-arterial PCO2 gradient affect the prognosis of septic patients admitted to the intensive care unit. Patients and Methods: A prospective observational clinicalp;01 study was accomplished in Iraq from April 2022 to December 2022. In the participation of 51 adult patients who fulfill the criteria of severe sepsis or septic shock, and admitted to the intensive care unit. And were divided on the base of ΔPCO2 into two groups; The high ΔPCO2 group(ΔPCO2 > 6 mmHg) including 30 participants and the normal ΔPCO2 (ΔPCO2 ≤ 6 mmHg) included 21 participants. Scoring systems were recorded. Clinical outcome including organ dysfunction and mortality was recorded in a duration of 10 days. Results: The high ΔPCO2 group showed significant high blood glucose level, Serum lactate, and heart rate (p = 0.010, 0.023, and 0.037 respectively) than the normal ΔPCO2 group. As regarding APACHE II score it shows high significance (p <0.001) in the high ΔPCO2 group than the normal one. As regard to the clinical outcome, patient mortality was statistically higher and significant (p = 0.035) in high ΔPCO2 group than normal ΔPCO2 group and the number of organ failure was higher in high ΔPCO2 group than normal group but not reached a significant level (p = 0.633). Conclusions: ΔPCO2 is a reliable indicator for early prediction of clinical outcome including end organ failure and mortality in patients with sepsis and septic shock.