Article Sidebar

pdf
Date Published: 09/04/2025
Abstract Views: 57
Views pdf: 34
DOI: https://doi.org/10.51298/vmj.v548i1.13317
Issue
Vol. 548 No. 1 (2025)
Section
Các bài báo
How to Cite
Đậu Việt, H., & Nguyễn Hoàng, S. (2025). CORRELATION OF CENTRAL VENOUS-TO-ARTERIAL CO₂ DIFFERENCE/ARTERIAL-TO-CENTRAL VENOUS O₂ DIFFERENCE RATIO WITH ROUTINE MONITORING PARAMETERS IN PEDIATRIC SEPTIC SHOCK. Vietnam Medical Journal, 548(1). https://doi.org/10.51298/vmj.v548i1.13317

CORRELATION OF CENTRAL VENOUS-TO-ARTERIAL CO₂ DIFFERENCE/ARTERIAL-TO-CENTRAL VENOUS O₂ DIFFERENCE RATIO WITH ROUTINE MONITORING PARAMETERS IN PEDIATRIC SEPTIC SHOCK

Hùng Đậu Việt, Sơn Nguyễn Hoàng

Main Article Content

Abstract

Objective: The central venous-to-arterial CO₂ difference (Cv-aCO₂) to central venous-to-arterial O₂ difference (Da-vO₂) ratio indicates the balance between oxygen supply and demand, helping in the early detection of tissue hypoxia. Along with the Cv-aCO₂/Da-vO₂ ratio, other parameters such as heart rate, mean arterial pressure, ScvO₂, lactate, etc., play an essential role in monitoring and treating septic shock in children. This study aims to determine the correlation between the Cv-aCO₂/Da-vO₂ ratio and routine monitoring parameters in managing pediatric septic shock. Methods: A prospective descriptive study was conducted on pediatric patients aged from 1 month to 16 years diagnosed with septic shock. Cv-aCO₂, Da-vO₂, mean arterial pressure, heart rate, lactate, ScvO₂, ΔpCO₂ (mmHg), and pH were recorded at the following time points: T0 (start of shock treatment), T6 (6 hours after treatment), T12 (12 hours after treatment), and T24 (24 hours after treatment). Cv-aCO₂, Da-vO₂, ΔpCO₂, and lactate were calculated from central venous and arterial blood gases, while ScvO₂ was derived from central venous blood gas analysis. Blood gas measurements were performed using the GEM 3500 analyzer. Results: In this study, no significant differences were observed in heart rate, mean arterial pressure, lactate, and ScvO₂ between the Cv-aCO₂/Da-vO₂ ≤ 1.0 and Cv-aCO₂/Da-vO₂ > 1.0 groups at T0, T12, and T24 (p > 0.05). However, ΔpCO₂ showed significant differences between the two groups (p < 0.05). The Cv-aCO₂/Da-vO₂ ratio was positively correlated with heart rate and lactate at T0 (r = 0.02, p = 0.85 and r = 0.03, p = 0.82), T6 (r = 0.01, p = 0.93 and r = 0.04, p = 0.75), and T24 (r = 0.18, p = 0.11 and r = 0.02, p = 0.86), and negatively correlated with mean arterial pressure and ScvO₂ at T0 (r = 0.05, p = 0.67 and r = 0.02, p = 0.84), T6 (r = 0.34, p = 0.76 and r = 0.22, p = 0.05), and T24 (r = 0.03, p = 0.82 and r = 0.05, p = 0.69). Conclusion: The Cv-aCO₂/Da-vO₂ ratio tends to positively correlate with heart rate and lactate and negatively correlate with ScvO₂ and mean arterial pressure.

Article Details

Keywords

septic shock, lactate, ScvO2, Cv-aCO₂, Da-vO₂, tỷ lệ Cv-aCO₂/Da-vO₂

References

1. Ospina-Tascón GA, Umaña M, Bermúdez W, et al. Combination of arterial lactate levels and venous-arterial CO2 to arterial-venous O2 content difference ratio as markers of resuscitation in patients with septic shock. Intensive Care Med. 2015;41(5): 796-805. doi:10.1007/s00134-015-3720-6
2. Ospina-Tascón GA, Madriñán HJ. Combination of O2 and CO2-derived variables to detect tissue hypoxia in the critically ill patient. J Thorac Dis. 2019;11(Suppl 11):S1544-S1550. doi:10.21037/ jtd.2019.03.52.
3. Weiss SL, Peters MJ, Alhazzani W, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Med. 2020 Feb;46(Suppl 1):10-67. doi: 10.1007/s00134-019-05878-6.
4. Janotka M, Ostadal P. Biochemical markers for clinical monitoring of tissue perfusion. Mol Cell Biochem. 2021;476(3): 1313-1326. doi:10.1007/ s11010-020-04019-8
5. Zang H, Shen X, Wang S, He Z, Cheng H. Evaluation and prognostic value of Cv-aCO2/Da-vO2 in patients with septic shock receiving fluid resuscitation Cv-aCO2/Ca-vO2. Exp Ther Med. 2019; 18(5): 3631-3635. doi:10.3892/etm. 2019.7956
6. He H, Liu D, Long Y, et al. High central venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio is associated with poor lactate clearance in septic patients after resuscitation. J Crit Care. 2016;31(1): 76-81. doi:10.1016/ j.jcrc. 2015.10.017.
7. Wittayachamnankul B, Chentanakij B, Sruamsiri K, et al. The role of central venous oxygen saturation, blood lactate, and central venous-to-arterial carbon dioxide partial pressure difference as a goal and prognosis of sepsis treatment. J Crit Care. 2016; 36:223-229. doi: 10.1016/j.jcrc.2016.08.002
8. Mesquida J, Saludes P, Gruartmoner G, et al. Central venous-to-arterial carbon dioxide difference combined with arterial-to-venous oxygen content difference is associated with lactate evolution in the hemodynamic resuscitation process in early septic shock. Crit Care Lond Engl. 2015;19:126. doi:10.1186/ s13054-015-0858-0