Diagnostic Validity of Ratio between Differences of Central Venous to Arterial CO2 and Arterial to Central Venous O2 Content in Diagnosis of Anaerobic Metabolism among Septic Patients

Background: Detection of anaerobic metabolism is very crucial for the management of the septic patients. Objective: The purpose of the present study was to validate the ratio between differences of central venous to arterial CO2 and arterial to central venous O2 content in diagnosis of anaerobic metabolism among septic patients. Methodology: This prospective observational study was conducted in the Intensive Care Unit of the department of Anaesthesia Analgesia, Palliative and Intensive Care Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2016 to December 2016. All patients admitted to ICU with the features of severe sepsis and septic shock according to SSC guidelines with the age of more than or equal to 18 years in both sexes were included in this study. The arterial and central venous blood gases were measure simultaneously. At the same time serum lactate was measured. Result: Among the 69 patients, 31(44.9%) were of severe sepsis and 38(55%) were of septic shock patients. In the severe sepsis and septic shock patients the mean P(v-a)CO2/C(a-v)O2 is 1.39±0.41 and 1.11±0.40 respectively. Serum lactate in case of severe sepsis and septic shock patients is 2.85±1.40 and 3.85±1.04 respectively. The ROC analysis showed an area under curve 0.89 and P(v-a)CO2/C(a-v)O2 ratio cutoff value of 1.21 showed sensitivity 0.84 and specificity 0.94. Conclusion: The P(v-a)CO2/C(a-v)O2 ratio is also a another marker of global anaerobic metabolism and it would be used for diagnosis as well as management of septic patient. Journal of Current and Advance Medical Research, January 2021;8(1):34-38

Download Full-text

Lactate levels from arterial, central venous and peripheral venous blood in severe sepsis and septic shock patients

Critical Care ◽

10.1186/cc5612 ◽

2007 ◽

Vol 11 (Suppl 2) ◽

pp. P452 ◽

Cited By ~ 1

Author(s):

M Assuncao ◽

A Nascente ◽

C Guedes ◽

B Mazza ◽

M Jacki ◽

...

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Venous Blood ◽

Central Venous ◽

Peripheral Venous Blood ◽

Lactate Levels ◽

Sepsis And Septic Shock

Download Full-text

Association of left ventricular longitudinal strain with central venous oxygen saturation and serum lactate in patients with early severe sepsis and septic shock

Critical Care ◽

10.1186/s13054-015-1014-6 ◽

2015 ◽

Vol 19 (1) ◽

Cited By ~ 20

Author(s):

Michael J. Lanspa ◽

Joel E. Pittman ◽

Eliotte L. Hirshberg ◽

Emily L. Wilson ◽

Troy Olsen ◽

...

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Oxygen Saturation ◽

Longitudinal Strain ◽

Central Venous Oxygen Saturation ◽

Serum Lactate ◽

Left Ventricular ◽

Central Venous ◽

Venous Oxygen Saturation ◽

Sepsis And Septic Shock

Download Full-text

Utility of venous blood gases in severe sepsis and septic shock

Baylor University Medical Center Proceedings ◽

10.1080/08998280.2018.1460133 ◽

2018 ◽

Vol 31 (3) ◽

pp. 269-275 ◽

Cited By ~ 1

Author(s):

Heath D. White ◽

Alfredo Vazquez-Sandoval ◽

Pedro F. Quiroga ◽

Juhee Song ◽

Shirley F. Jones ◽

...

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Venous Blood ◽

Blood Gases ◽

Sepsis And Septic Shock

Download Full-text

Is Presepsin a Reliable Marker of Sepsis Diagnosis in Pediatric Intensive Care Unit?

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.3431 ◽

2020 ◽

Vol 8 (B) ◽

pp. 66-70

Author(s):

Hebat-Allah Algebaly ◽

Hala M. Fouad ◽

Maha M. Elkholy ◽

Sally K. Ibrahim ◽

Nermin M. Riad

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Intensive Care ◽

Consensus Conference ◽

University Teaching ◽

Control Group ◽

Healthy Children ◽

International Consensus ◽

Critical Patients ◽

Sepsis And Septic Shock

BACKGROUND: Sepsis is a major challenge in emergency departments and intensive care units (ICUs). Sepsis also mimics or interacts with many other disorders causing high mortality and morbidity. There is no accurate biomarker or test to diagnose or predict sepsis. The treatment of sepsis is often based on the clinician’s experience. AIM: We conducted this study to analyze the serum level of presepsin in pediatric critical patients with SIRS, sepsis, severe sepsis, and septic shock. METHODS: The study included 58 children, 32 septic pediatric patients admitted to the Pediatric ICU (PICU) of Cairo University Teaching Hospital and 26 healthy children who served as a control group. The aim was to estimate the diagnostic accuracy of presepsin in predicting sepsis in PICU. We classified the patients into systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock according to the international consensus conference criteria. RESULTS: In our study, we detected a positive correlation between C-reactive protein and presepsin levels at day 1 and day 3 of admission and a negative correlation between hemoglobin and presepsin levels at day 1. However, we found no difference in the serum presepsin between the children who had sepsis and the healthy ones (at day 1 [p = 0.430) and at day 3 [p = 0.845]). We also found that serum levels of presepsin were not significantly increased with the increasing severity of sepsis despite the higher median values with increasing sepsis severity. CONCLUSIONS: It was noted that presepsin levels increased in anemic critical patients, whereas presepsin had no role in differentiating the septic critical patients from healthy children. However, its level increased with increasing severity of sepsis grade.

Download Full-text

Predictive Value of Soluble Programmed Death-1 for Severe Sepsis and Septic Shock During the First Week in an Intensive Care Unit

Shock ◽

10.1097/shk.0000000000001171 ◽

2019 ◽

Vol 51 (3) ◽

pp. 289-297 ◽

Cited By ~ 7

Author(s):

Yongzhen Zhao ◽

Yumei Jia ◽

Chunsheng Li ◽

Rui Shao ◽

Yingying Fang

Keyword(s):

Intensive Care Unit ◽

Septic Shock ◽

Severe Sepsis ◽

Intensive Care ◽

Predictive Value ◽

Programmed Death ◽

Programmed Death 1 ◽

Sepsis And Septic Shock

Download Full-text

The influence of intra-aortic balloon counter pulsation on central venous blood oxygen saturation

Perfusion ◽

10.1177/02676591211055968 ◽

2021 ◽

pp. 026765912110559

Author(s):

Ayman Mohamed ◽

Sameh Aboulnaga ◽

Fayez Hamwi ◽

Amr S Omar ◽

Abdulrasheed Pattath ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Oxygen Saturation ◽

Venous Blood ◽

Blood Gases ◽

Left Ventricular ◽

Arterial Oxygen ◽

Secondary Outcome ◽

Central Venous ◽

Significant Difference

Objectives We aim at identifying the changes in venous blood saturation values that associates intra-aortic balloon pump (IABP) in cardiac surgery patients with reduced left ventricular function (LVF). Methods A retrospective observational study was conducted in a cardiothoracic intensive care unit (CTICU) in a tertiary cardiac center over 5 years in Qatar. A total of 114 patients with at least moderate impairment of LVF with ejection fraction (EF) less than 40% were enrolled. According to the association of IABP, patients were segregated into two groups with and without IABP (groups 1, 40 patients and group 2, 74 patients). Sequential arterial and venous blood gases were analyzed. The primary outcome was to analyze the changes in the central venous saturation (ScvO2) in both groups and the secondary outcome was to analyze whether these changes affect the overall outcome in terms of intensive care unit (ICU) length of stay. Results There was no significant difference between both groups with regard to age, preoperative EF, hemoglobin, and arterial oxygen saturation (SaO2) in blood gases. Patients with IABP have a higher cScvO2 when compared to the other group (71.5 ± 12.5 vs 63.5 ± 9.3, 68.3 ± 12.6 vs 60.1 ± 9.5, 62.7 ± 10.8 vs 55.63 ± 8.1, and 60.6 ± 7.6 vs 54.9 ± 8.1; p = 0.04, 0.05, 0.03, and 0.5, respectively). However, generalized estimating equations (GEE) analysis showed that compared with the participants showing that there is a decreasing trend in mean levels within the groups during follow-ups, overall difference between both groups’ mean levels was not statistically significant. Conclusions In this study, we observed that after cardiac surgeries, patients with IABP had non-significant higher ScvO2 when compared with a corresponding group with moderate impairment of LVF. Further prospective studies are required to validate these findings.

Download Full-text

Sepsis

10.2310/fm.1147 ◽

2020 ◽

Author(s):

Steven P LaRosa ◽

Steven M. Opal

Keyword(s):

Intensive Care Unit ◽

Septic Shock ◽

Severe Sepsis ◽

Intensive Care ◽

Organ Dysfunction ◽

Fluid Resuscitation ◽

Multiorgan Failure ◽

Sepsis Management ◽

The Past ◽

Sepsis And Septic Shock

Sepsis, along with the multiorgan failure that often accompanies this condition, is a leading cause of mortality in the intensive care unit. Although modest improvements in the prognosis have been made over the past two decades and promising new therapies continue to be investigated, innovations in the management of septic shock are still required. This chapter discusses the definitions, epidemiology, and pathogenesis (including microbial factors, host-derived mediators, and organ dysfunction) relating to sepsis. Management of severe sepsis and septic shock is also described. This review contains 5 figures, 11 tables, and 99 references. Keywords:Organ dysfunction, sepsis, septic shock, infection, bacteremia, fluid resuscitation, vasopressor

Download Full-text

Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock

50 Studies Every Anesthesiologist Should Know ◽

10.1093/med/9780190237691.003.0020 ◽

2018 ◽

pp. 104-108

Keyword(s):

Intensive Care Unit ◽

Emergency Department ◽

Septic Shock ◽

Severe Sepsis ◽

Intensive Care ◽

Oxygen Demand ◽

Goal Directed Therapy ◽

Early Goal Directed Therapy ◽

Study Results ◽

Sepsis And Septic Shock

This case focuses on detecting sepsis through early goal-directed therapies by asking the question: Does aggressive correction of hemodynamic disturbances in the early stages of sepsis improve outcomes? Early goal-directed therapies are aimed at restoring a balance between oxygen delivery and oxygen demand. Patients included in the study were adults presenting to the emergency room with severe sepsis or septic shock. Study results indicated that most patients with severe sepsis or septic shock should be managed with aggressive hemodynamic monitoring and support immediately on presentation in the emergency department (or, if this is not possible, in the intensive care unit) for 6 hours or until there is resolution of hemodynamic disturbances.

Download Full-text