Document Detail


Gastric capnometry with air-automated tonometry predicts outcome in critically ill patients.
MedLine Citation:
PMID:  12576954     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Contrary to tonometer gastric intramucosal pH, there is currently no validated threshold prognostic value for Pco2 gap (tonometer gastric mucosal Pco2 minus arterial Pco2) in the critically ill patient. OBJECTIVE: To demonstrate a relationship between Pco2 gap and mortality in mechanically ventilated patients. DESIGN AND SETTING: Inception cohort study from a 9-month prospective survey of 95 consecutively ventilated critically ill patients in a teaching hospital. PATIENTS: All the ventilated patients of the intensive care unit were included at their admission. MEASUREMENTS AND MAIN RESULTS: Gastric Pco2 using regional capnometry with air-automated tonometry, arterial gas, lactate, and organ system failure score were measured at admission and after 6, 12, 24, 48, 72, 96, and 120 hrs. For the entire population, the 28-day mortality was 44%. In multivariate analysis, independent predictors of death were organ system failure score (odds ratio, 2.12; 95% confidence interval, 1.02-3.14), 24-hr Pco2 gap (odds ratio, 1.57; 95% confidence interval, 1.10-2.24), and 24-hr lactate (odds ratio, 1.48; 95% confidence interval, 1.06-2.05). We found a threshold value of 20 mm Hg for Pco2 gap and 2.5 mmol/L for lactate, which was associated with a sensitivity of 0.70 and 0.72, respectively, and a specificity of 0.72 and 0.73, respectively. CONCLUSION: The Pco2 gap is a marker of mortality in ventilated patients in the intensive care unit.
Authors:
Bruno Levy; Pascale Gawalkiewicz; Benoit Vallet; Serge Briancon; Lionel Nace; Pierre-Edouard Bollaert
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  31     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-10     Completed Date:  2003-03-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  474-80     Citation Subset:  AIM; IM    
Affiliation:
Réanimation Médicale, Hôpital Central, Nancy, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Air
Blood Gas Analysis / methods*
Carbon Dioxide / blood*
Cohort Studies
Critical Illness / mortality,  therapy*
Gastric Mucosa
Humans
Manometry
Middle Aged
Predictive Value of Tests
Prognosis
Survival Rate
Treatment Outcome
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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