BACKGROUND
PROGNOSTIC VALUE OF ARTERIAL BLOOD GAS IN PATIENTS WITH SEPSIS AND SEPTIC SHOCK
Nguyen Tat Dung 1,3, Mai Xuan Than 2, Tran Đuc Huy 1, Phan Van Minh Quan 1, Nguyen Xuan Khoi 1, Dương Thai Duy 1
` 1. Hue Central Hospital;
2 .Binh Dinh Hospital;
3. Da Nang University of Medical Technology and Pharmacy.
RESULTS
METHODS
CONFERENCES
LOGO
HERE
CONCLUSION
*Main author contact information:
Name: Nguyen Tat Dung
Organization: Hue Central Hospital
Address: 16 Le Loi str. Hue city- Vietnam
Email: ngtatdung2015@gmail.com
Phone No.: 0899875126
Metabolic acidosis is commonly associated with the disease severity in patients with sepsis or septic shock. The severity of metabolic acidosis is associated with poor clinical outcomes. We hypothesized that some values of arterial blood gases could be used to predict prognosis for mortality rate in patients with sepsis or septic shock.
A prospective descriptive observational study carried on 54 patients with sepsis or septic shock according to SSC 2016 criteria. Arterial blood gases and serum lactate were performed at three time points at 0 hours (T0), 6 hours (T6) and 24 hours (T24) since the confirmed diagnosis.
The overall mortality rate was 66.7 %. The rates with pH value below 7.35 were 50.0%, 46.3% and 53.7%at T0, T6 and T24, correspondingly (tab.1). pH value had fair predictive value for mortality with AUC- ROCs of 70.8% (95%CI: 57.2- 84.4) and 76.6% (95%CI: 63.9- 89.4) at the time of T0 and T24, respectively. HCO3- had a fair value in the prognosis mortality with an AUC-ROC of 72.2% (95%CI: 58.4- 85.4) at the time point of T0. BE was fair for predicting mortality with AUC- ROC values of 71.5% (95%CI: 58.0- 84.9) and 70.8% (95%CI: 56.7- 84.8) at the time of T0 and T24, respectively (Fig.1). AG value was found to be fairly effective in predicting mortality to sepsis with an AUC- ROC 75.7% (95%CI: 62.5- 91.4) at T0. PaCO2 and PaO2/FiO2 were not significant predictors of death.
Tab. 1: Blood Gas Analysis Results and Serum Lactate Levels in the septic patients | |||
Value (Mean ± SD) | T0 | T6 | T24 |
pH | 7.32 ± 0.17 | 7.34 ± 0.13 | 7.31 ± 0.16 |
PaCO2(mmHg) | 38.55 ± 23.21 | 38.58 ± 18.05 | 41 ± 17.17 |
HCO3-(mmol/L) | 19.23 ± 8.31 | 20.25 ± 8.62 | 20.38 ± 7.56 |
BE | -6.08 ± 8.91 | -5.11 ± 8.49 | -4.74 ± 9.43 |
PaO2(mmHg) | 110.82 ± 65.51 | 106.82 ± 46.93 | 95.17 ± 39.1 |
PaO2/FiO2(mmHg) | 293.5 ± 168.9 | 274.9 ± 150.7 | 234.1 ± 140.3 |
Lactate (mmol/L) | 5.66 ± 4.46 | 5.33 ± 4.03 | 4.62 ± 3.73 |
Fig.1: Receiver-operating characteristic curve of arterial blood gas pH, HCO3 and BE for predicting hospital mortality rate in patients with sepsis and septic shock.
pH
HCO3
BE
Some values of arterial blood gases such as pH, HCO3-, BE and AG had fair predictive values for mortality in patients with sepsis and septic shock.
Multicenter prospective studies with a larger sample size are needed to confirm our results.
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2. White H. D.. Vazquez-Sandoval A.. Quiroga P. F.. et al (2018). "Utility of venous blood gases in severe sepsis and septic shock". Proc (Bayl Univ Med Cent). 31(3). pp. 269-275.
3. Zhu Y.. He Z.. Han S.. et al (2022). "Serum Anion Gap Level Predicts All-Cause Mortality in Septic Patients: A Retrospective Study Based on the MIMIC III Database". Journal of Intensive Care Medicine. 38 (4). pp. 349- 357.