EVALUACION DEL DELTA DE CO2 Y SATURACION VENOSA CENTRAL EN EL PACIENTE CRITICO ONCOLOGICO CON SHOCK SEPTICO DURANTE LA FASE INICIAL DE RESUCITACION EN EL HOSPITAL JUAN TANCA MARENGO SOLCA DE LA CIUDAD DE GUAYAQUIL EN EL PERIODO DE ENERO HASTA OCTUBRE DEL 2018.

Abstract

Objective: To evaluate the levels of arterio-venous CO2 difference and central venous saturation in the initial resuscitation of oncological patients diagnosed with septic shock admitted to the Intensive Care Unit of the SOLCA Guayaquil Hospital. Methods: We conducted an observational, non-experimental, descriptive and analytical study in which 59 patients with diagnosis of septic shock were selected from the Intensive Care Service of the SOLCA Guayaquil Hospital, between January and October of 2018. The patients were assigned to two groups according to the value delta CO2 at entry; <6 mmHg or> 6 mmHg, and central venous saturation> 70% or <70%, determining its evolution at 6 and 24 hours after the start of hemodynamic resuscitation. Results: It was demonstrated that the CO2 delta> 6 mmHg in the first 24 hours correlated with a poor prognosis despite having a normal SvcO2. We also found a mortality of 41% in solid tumors and 39% in hematological tumors, with an OR: 1.1 (P: 0.0001), no statistically significant difference was found. Conclusions: Patients with elevated CO2 delta during the first hours of admission to the ICU have higher mortality. SvcO2> 70% within the first few hours of resuscitation are not associated with decreased mortality.