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PROGNOSTIC VALUE OF CENTRAL VENOUS -ARTERIAL CO₂ DIFFERENCE TO ARTERIAL - CENTRAL VENOUS O₂ DIFFERENCE RATIO IN PEDIATRIC SEPTIC SHOCK
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Abstract
Objective: Septic shock is a condition characterized by an imbalance between oxygen supply and consumption, leading to tissue hypoxia, multi-organ failure, and high mortality rates. Early identification of tissue hypoxia is a critical factor in treating shock. The study aims to assess the predictive value of the central venous -arterial CO₂ difference (Cv-aCO₂) to arterial - central venous O₂ difference (Da-vO₂) ratio in managing pediatric patients with septic shock. Methods: This was a prospective descriptive study. All children diagnosed with septic shock were included. The Cv-aCO₂ and Da-vO₂ indices were collected and calculated from central venous and arterial blood gases using the GEM 3500 analyzer at specific time points: T0 (at the start of shock treatment), T6 (6 hours post-treatment), T12 (12 hours post-treatment), and T24 (24 hours post-treatment). Treatment outcomes were assessed based on duration of mechanical ventilation (days), length of stay in the intensive care unit (ICU) (days), and survival or mortality. Results: Among the 81 patients included in the study, 64 patients survived (79%), with a median mechanical ventilation duration of 9.1 days (range: 0–28) and a median ICU stay of 12.3 days (range: 1–28). The Cv-aCO₂/Da-vO₂ ratio cutoff value of 1 at the start of treatment (T0) allowed differentiation between the survival and mortality groups, with an ROC of 0.604 (95% CI: 0.45–0.76), sensitivity of 76.6%, and specificity of 88%. The Cv-aCO₂/Da-vO₂ ratio was significantly associated with the prognosis for mechanical ventilation duration and ICU length of stay. Conclusion: The Cv-aCO₂/Da-vO₂ ratio is a promising index for evaluating mechanical ventilation duration, ICU length of stay, and mortality prognosis in pediatric patients with septic shock
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Keywords
septic shock, Cv-aCO₂, Da-vO₂, tỷ lệ Cv-aCO₂/Da-vO₂
References
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