Background: Following major surgery, hypoxia is considered a key contributor to organ failure postoperatively, as well as mortality. Decreased oxygen saturation in the central veins (ScvO₂) has been linked to organ failure in the postoperative period. However, there are data suggesting that variables based on oxygen availability have a weak relationship with anaerobic metabolism.
Objective: To evaluation of clinical significance of elevated values of the central venous to arterial carbon dioxide gap (PCO₂ gap) among critical care unit cases at high risk for complications following surgery.
Patients and Methods: Our study was randomized controlled trial (RCT) study, performed in El Sahel Teaching Hospital in duration from March 2019 to March 2021. We included 30 postoperative patients. Patients were categorized according to presence of complication to group I and II, and according to PCO₂ gap to groups A and B.
Results: Cases who had high PCO₂ gap equal or more than 6 mmHg experienced significantly extended duration of mechanical ventilation (median1 day among group I vs. 0 days among group II, p-value = 0.017), length of ICU stay (median 5.5 days among group I vs. 4 days among group II, p-value = 0.03), length of hospital stay (median 17.5 days among group I vs. 11.5 days among group II, p-value <0.001), and organ failure (15 cases among group I vs. 1 case among group II, p-value = 0.007).
Conclusion: High-risk surgical patients benefited from fewer complications, shorter times on mechanical ventilation and in the intensive care unit (ICU), and shorter hospital stays when their hemodynamic status was optimized after surgery using a PCO₂ gap of less than 6 mmHg as a guide.