الفهرس 
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Abstract
Central venous-to-arterial carbon dioxide difference as a predictor for mortality and morbidity in septic patient
Abstract
Background : management of sepsis is largely supportive, which was given a huge importance to study factors that could predict the outcome in patients suffering from sepsis and early recognition of signs of tissue hypoperfusion and their value during resuscitation. The P(cv-a) CO2 value has been proposed as a parameter capable of indicating altered tissue perfusion in these patients.Aim of the work: The purpose of this study is to evaluate the clinical relevance of high value of the P(cv-a)CO2, and its relationships to other marker of impaired tissue perfusion and oxygenation (blood lactate) and if it can be used as a predictor for mortality and morbidity in septic patients .patients and methods: This prospective observational study was carried out in Ain Shams University hospitals the study was performed over 40 adult patients of either sex aged from forty to sixty years old admitted to the ICU suffering from sepsis (defined as Table 3), patients from uncontrolled source of sepsis were excluded from the study. Patients included in the study were followed through the first 24 hours of ICU admission. Results:results from the study showed that lactate clearance from T0 to T12 was significantly higher in the low gap patients than high gap patients -42 ± 27 % versus -22 ± 30 %, p = 0.032). Low P (cv-a) CO2 patients presented a significantly lower SOFA score on day one when compared to high P(cv-a) CO2 patients: (P = 0.016) and on day 15 (P = <0.001). Whereas there was no significant difference between the two groups in 28 day mortality (p = 0.058). Conclusion: High P (cv-a) CO2 (>6 mmHg) in ICU patients suffering from sepsis may have a prognostic value, which was evident by higher SOFA score and slower Lactate clearance. However, ICU length of stay and 28-day mortality were not significantly different when compared to patients with P (cv-a) CO2 (< 6 mmHg). So, P (cv-a) CO2 is related to morbidity rather than mortality.