Concordance of co2gaps measured using peripheral and central venous blood in patients diagnosed with septic shock Concordancia de las brechas de CO2medidas en sangre venosa periférica y central en pacientes diagnosticados de choque séptico

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YALÇINKAYA E., KASAPOĞLU U. S., ARIKAN H., Sahin N. O., Yildiz B., Tekin E., ...Daha Fazla

Cirugia y Cirujanos, cilt.93, sa.6, ss.613-619, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 93 Sayı: 6
  • Basım Tarihi: 2025
  • Doi Numarası: 10.24875/ciru.24000617
  • Dergi Adı: Cirugia y Cirujanos
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.613-619
  • Anahtar Kelimeler: Hemodynamic monitoring, Pv-aCO2.Tissue perfusion, Septic shock, Veno-arterial CO2difference
  • Marmara Üniversitesi Adresli: Evet

Özet

Objective: This study evaluates the venous-arterial CO2difference (Pv-aCO2) from peripheral venous blood (Pv-aCO2p) as a less invasive alternative to central venous Pv-aCO2for assessing tissue perfusion in septic shock. Methods: A prospective, single-center study included 54 septic shock patients with central venous catheters placed within 24 h of intensive care unit admission. Blood samples from arterial, central venous, and peripheral venous sources were analyzed. Correlation analyses and Bland-Altman plots were used to assess agreement between Pv-aCO2p and central Pv-aCO2. Results: Patients had a mean age of 70 years, and 51.9% were male. The median SOFA score was 8.5, and the mean APACHE-II score was 22.7. The Pv-aCO2p gap was 8 mmHg, whereas the central Pv-aCO2gap was 6 mmHg. A moderate correlation was found between Pv-aCO2p and central Pv-aCO2(r = 0.593, p < 0.001), with stronger correlations observed in patients with arterial lactate ≥ 2 mmol/L (r = 0.673) and hemoglobin <8 g/dL (r = 0.625). Bland-Altman analysis revealed a mean difference of 8.278 mmHg between arterial and peripheral pCO2. Conclusions: Peripheral Pv-aCO2p correlates well with central Pv-aCO2and can serve as a less invasive alternative for assessing tissue perfusion in septic shock patients. It offers practical utility when central venous access is not available, aiding in early clinical decisions.