Kyung Sook Hong PhD , Jae Gil Lee PhD , Tae Yoon Kim MD , Jae-myeong Lee PhD , Hoonsung Park MD , Hanyoung Lee MD , Na Rae Yang PhD , Seung Min Baik MD
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引用次数: 0
Abstract
Background
The arterial to end-tidal carbon dioxide gradient (P [a-Et] CO2) reveals the ventilation-perfusion (V/Q) status of critically ill patients. V/Q mismatch has several causes and affects the clinical outcomes of critically ill patients. We investigated the relationship between P (a-Et) CO2 and the clinical outcomes in critically ill patients.
Methods
Critically ill patients (n = 1,978) on mechanical ventilation and capnography in the intensive care units of two institutions were enrolled and categorized into three groups: P (a-Et) CO2 ≤10 mmHg (low group), 10 mmHg < P (a-Et) CO2 ≤ 20 mmHg (medium group), and 20 mmHg < P (a-Et) CO2 (high group).
Results
The Acute Physiology and Chronic Health Evaluation II score was 29.5 ± 8.1, 31.3 ± 8.2, and 33.3 ± 8.7 in the low, medium, and high groups, respectively (p < 0.001). Overall mortality rates were 25.5 %, 35.6 %, and 52.8 % in the low, medium, and high groups, respectively (p < 0.001). The odds ratio was 1.456 (95 % confidence interval [CI]: 1.117–1.897, p = 0.002) and 2.320 (95 % CI: 1.635–3.293, p < 0.001) for the medium and high groups, respectively, with the low group as a reference. The area under the receiver operating characteristic curve of P (a-Et) CO2 for overall mortality was 0.604 (p < 0.001).
Conclusions
P (a-Et) CO2 is a simple, easily accessible indicator that potentially impacts patient care and outcomes as an independent marker for assessing disease severity and predicting mortality, especially in non-respiratory critical care scenarios.
期刊介绍:
The American Journal of The Medical Sciences (AJMS), founded in 1820, is the 2nd oldest medical journal in the United States. The AJMS is the official journal of the Southern Society for Clinical Investigation (SSCI). The SSCI is dedicated to the advancement of medical research and the exchange of knowledge, information and ideas. Its members are committed to mentoring future generations of medical investigators and promoting careers in academic medicine. The AJMS publishes, on a monthly basis, peer-reviewed articles in the field of internal medicine and its subspecialties, which include:
Original clinical and basic science investigations
Review articles
Online Images in the Medical Sciences
Special Features Include:
Patient-Centered Focused Reviews
History of Medicine
The Science of Medical Education.