∆PCO2 as a marker of outcome in patients admitted to ICU, No: V1.0,
Research type
Research Study
Full title
Association of clinical outcomes with central venous-arterial PCO2 difference in patients admitted to the Intensive Care Unit
IRAS ID
179211
Contact name
Sonia Hudson
Contact email
Sponsor organisation
Mid Essex Hospital Services
Duration of Study in the UK
0 years, 6 months, days
Research summary
Sepsis is the systemic response to infection. In a significant proportion of patients, sepsis results in organ failure, and is associated with high death rates and morbidity.
A key problems in sepsis is the failure of tissues to adequately use oxygen. Attempts to improve outcome by optimising oxygen delivery to the tissues have largely failed. Recent evidence suggests that the conventional markers of global oxygen delivery (mixed venous oxygen saturation) has been within normal limits despite demonstrable abnormalities in tissue oxygenation. Such abnormalities persist even when mixed venous oxygen saturation is corrected from sub-normal to physiologically appropriate levels in patients with sepsis. It is clear from these results that after early resuscitation, markers of global oxygen delivery do not accurately guide life-saving supportive management in sepsis.
The difference in blood carbon-dioxide (PCO2) levels between the central venous and arterial sides of the vascular system has emerged as a sensitive marker for tissue oxygen utilisation. The difference in PCO2 levels have been shown to discriminate between sub-optimal oxygen delivery and problems in tissue oxygen utilisation, which appear similar clinically, but should be treated differently. In addition, sustained increase in PCO2 difference is also associated with death in the Intensive Care Unit.
Studies investigating PCO2 difference in ICU have been well designed but have been restricted to patients with sepsis and limited by small sample sizes. We hypothesise that the mechanisms underlying oxygen delivery in sepsis also applies to other patients in the ICU. The aim of this study is to investigate the utility of PCO2 difference in identifying patients with abnormal oxygen utilisation in all patients admitted to ICU and correlate these differences with clinical outcomes.
REC name
South East Scotland REC 02
REC reference
15/SS/0163
Date of REC Opinion
8 Sep 2015
REC opinion
Unfavourable Opinion