: Identification of tissue hypoxia and hypoperfusion plays an important role in the management of critically ill patients. Although the venous-arterial PCO difference (ΔPCO) cannot serve as a marker of tissue hypoxia, it is considered a marker of the adequacy of venous blood flow (Cardiac output). The present study aimed to evaluate the role of venous-arterial PCO gradient in prediction of outcome in septic patients admitted to ICU.
: 100 adult patients fulfilled the criteria of severe sepsis or septic shock admitted to Emergency Intensive Care Unit, were divided in two groups according to ΔPCO. The high ΔpCO group (ΔpCO > 6 mmHg) included 58 patients and the normal ΔpCO (ΔpCO ≤ 6 mmHg) included 42 patients. Clinical scoring systems were recorded. Clinical outcome including organ dysfunction and mortality was recorded.
: The high ΔPCO group showed significant lower blood glucose level (p = 0.038) than the normal ΔPCO group. Serum lactate, heart rate, and APACHE score were significantly higher in high ΔPCO group than normal ΔPCO group (p, 0.012, 0.013, and 0.020, respectively). As regard to the clinical outcome, patient mortality was significantly higher (p = 0.042) in high ΔPCO group than normal ΔPCO group and the number of organ dysfunction was higher in high ΔPCO group than normal ΔPCO group but not reached a significant level (p = 0.625).
: ΔPCO is a reliable index for early prediction of clinical outcome including organ dysfunction and mortality in patients with sepsis and septic shock.