MEDICIÓN DE LA DIFERENCIA DE DIÓXIDO DE CARBONO VENOSO CENTRAL - ARTERIAL CON LA DIFERENCIA ARTERIOVENOSA DEL CONTENIDO DE OXÍGENO COMO PARÁMETRO DE HIPOPERFUSIÓN EN LA RESUCITACIÓN TEMPRANA DEL SHOCK SÉPTICO

Abstract

INTRODUCTION: Septic shock is one of the most common causes of hospitalization in the Intensive Care Units (ICU) worldwide, its incidence in recent years increased and requires the use of large resources both human and material. OBJECTIVE: To determine the usefulness of measuring the centralarterial venous carbon dioxide difference with the arteriovenous difference in oxygen content (PcvaCO2 / CavO2) as a parameter of hypoperfusion in X the early resuscitation of septic shock at the Luis Vernaza Hospital during the Period of time from July 1, 2015 to June 30, 2016. SAMPLE: We studied 53 patients hospitalized for more than 24 hours in the Intensive Care Unit of the Luis Vernaza Hospital who entered with a diagnosis of septic shock and who had samples of arterial and central venous catheter blood samples. METHODS: Data were obtained from electronic medical records. Age, sex, APACHE II, SOFA, organ failure, etiology of sepsis, length of ICU stay, ICU discharge condition, PcvaCO2 / CavO2; The descriptive analysis was expressed in: frequencies, percentages, means, fashion, median with use of tables and graphs; The inferential statistical analysis was expressed by Chi Square, Spearman correlation coefficient and Odds Ratio. DISCUSSION: In this study, when relating the number of organic faults and high PcvaCO2 / CavO2 a good Spearman correlation coefficient of r = + 0.96 was obtained, by associating the APACHE II and SOFA Scores with PcvCO2 / CavO2 it was observed that as the score The number of patients with a PcvaCO2 / CavO2 greater than 1.68 mmHg / ml increased; With respect to the number of organic failures, as it increased, so did the number of patients with PcvaCO2 / CavO2 greater than 1.68 mmHg / ml; There is a survival of 60.4% compared to a mortality of 39.6% despite being a group of patients with a high risk of mortality, the relationship between the ICU discharge condition and PcvaCO2 / CavO2 in this study gave an Odds Ratio of 1.19 And a non-significant p, no direct correlation between the days of stay in ICU and the PcvaCO2 / CavO2 was observed;