VALOR DEL ÍNDICE V-A DE PCO2 COMO PREDICTOR TEMPRANO DE HIPOXIA TISULAR EN PACIENTE CRÍTICO

Abstract

Background: Monitoring of tissue oxygenation is essential for critically ill patients, since this value is required to guide therapy and to calculate prognostic scales scores. In spite of this, the parameters routinely used for this purpose such as DO2 and VO2 as well as the SOFA prognostic score can not always provide immediate information and are not readily available because their implementation implies Specials technical and technological difficulties, which are not always available. It has been suggested that the arterio-venous index of the Carbon dioxide Pressure (Iv-aPCO2) is a method that can be performed as a bedside test, especially in those critical patients with a pulmonary artery catheter and who provides at least theoretically an approximation to the level of tissue oxygenation, however. This validity has been questioned. Objective: A study was conducted to determine if the measurement of Iv-aPCO2 was an early predictor of tissue hypoxia in critically ill patients. Methodology: In the Teodoro Maldonado Hospital’s - Intensive Care Unit from Guayaquil, Ecuador, a cross-section study was carried out in which 43 consecutive cases of critical patients were included, which were measured and calculated several parameters that indicate the level of tissue oxygenation. Pearson's index was used to establish the degree of correlation and values of P <0.05 were considered significant. Results: The results showed that, in a logical manner, most of the critical patient assessment parameters were altered reflecting the patient's condition (IC, IVS, IRVS, EO2, CqO2, CvO2, PAM, VU, SvO2, PaCO2, PvCO2, Hb SO2, PaO2). There was also no correlation between the values of VO2 (R = 0.24, P 0.128), DO2 (R = 0.16, P 0.308) and SOFA (R, 113, P 0.472) with Iv-aPCO2 values. Conclusion: IvaPCO2 cannot replace the traditional values of tissue oxygenation evaluation in critical patients, but it should be used as a general part of the evaluation because it provides valuable and complementary information