RecruitingNCT07096284

The PvCO2-PaCO2/CaO2-CvO2 Ratio in Septic Shock

Prognostic Value and Kinetics of the PvCO2-PaCO2/CaO2-CvO2 Ratio Compared to Arterial Lactate in the Initial Phase of Septic Shock

Sponsor

Avicenna Military Hospital

Enrollment

30 participants

Start Date

Jan 5, 2025

Study Type

OBSERVATIONAL

Conditions

Septic Shock

Summary

The ratio of the venous-arterial carbon dioxide partial pressure difference to the arteriovenous oxygen content difference (Pv-aCO₂/Ca-vO₂) may be a marker of anaerobic metabolism in patients with acute circulatory failure. This study aims to assess the prognostic value of the PvCO2-PaCO2/CaO2-CvO2 in the early phase of septic shock.

Eligibility

Min Age: 18 Years

Inclusion Criteria1

Patients aged over 18 years presenting with septic shock, defined as sepsis with persistent hypotension requiring vasopressors to maintain a mean arterial pressure (MAP) ≥ 65 mmHg and lactatemia \> 2 mmol/L despite adequate fluid resuscitation. Sepsis is defined by the presence of a suspected or confirmed infectious source associated with organ dysfunction (neurological, respiratory, renal, hepatic, or hematological). \[Sepsis 3 criteria\]

Exclusion Criteria2

Absence of central venous access.
Central venous access not positioned in the superior vena cava (e.g., femoral access).

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Interventions

DIAGNOSTIC_TESTPvCO2-PaCO2/CaO2-CvO2 ratio

Patients diagnosed with septic shock will undergo serial measurements of arterial and venous blood gas analyses, arterial lactate levels, and calculation of the Pv-aCO₂/Ca-vO₂ ratio at predefined time points: H0 (baseline), H2, H6, H12, and H24. Calculation Formulas: 1. Arterial Oxygen Content (CaO₂):CaO2 = SaO2 × Hb × 1,34 + PaO2 × 0,0031 2. Venous Oxygen Content (CvO₂):CvO2 = SvO2 × Hb × 1,34 + PvO2 × 0,0031 3. Pv-aCO₂/Ca-vO₂ Ratio: P(v-a) CO2/C(a-v)O2=(PcvCO2-PaCO2)/(CaO2 -CcvO2).