Association of Arterio-Venous Oxygen and Carbon Dioxide Gradients With Tissue Hypoperfusion and Mortality in Sepsis
Association of Arterio-Venous Oxygen and Carbon Dioxide Gradients With Tissue Hypoperfusion and Mortality in Sepsis
In patients with sepsis who are treated in the intensive care unit under invasive mechanical ventilation, the combined evaluation of ScvO₂ and PcvCO₂ may provide a comprehensive insight into tissue oxygenation and metabolic stress, allowing a more precise hemodynamic assessment in critically ill patients. The aim of this study is to evaluate the monitoring of ScvO₂, PcvCO₂, and EtCO₂ in intensive care patients in order to predict hemodynamic instability, 28-day mortality, and length of ICU stay, as well as to investigate their effects on cardiac output, tissue oxygenation, and hypoperfusion.
In intubated patients admitted to the intensive care unit due to sepsis and receiving inotropic support, placement of a central venous catheter and blood gas analysis, as well as radial artery cannulation for invasive hemodynamic monitoring, are routinely performed. In these patients, ScvO₂ and ScvCO₂ measurements are obtained via the central venous catheter. End-tidal CO₂ (EtCO₂) is measured using capnography. Arterial blood gas analysis, including SaO₂ and PaCO₂, is performed through the radial arterial catheter. Data recorded at admission and at 6, 12, and 24 hours will be evaluated. Additional hemodynamic parameters, including heart rate, blood pressure, arterial blood gas values (pH, PaCO₂, HCO₃-), serum lactate levels, and cardiac output, will also be analyzed. Finger-tip perfusion index is measured using a pulse oximetry probe. Outcomes such as duration of mechanical ventilation, length of ICU stay, and 28-day mortality and morbidity will be assessed in conjunction with APACHE II and SOFA scores.
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