Prognostic value of transcutaneous tissue pressure of oxygen and carbon dioxide in sepsis shock patients

doi:10.3969/j.issn.1002-1949.2015.03.005

Abstract：Objective To investigate the value of transcutaneous tissue pressure of O2 and CO2 ( tcpO2 and tcpCO2 ) in the assessment of the microcirculation and the prognosis of patients with sepsis shock.Methods Thirty patients, admitted to ICU from June 1 in 2013 to March 31 in 2014, diagnosed with sepsis shock were studied.We monitored the arterial pressure of O2 and CO2 ( PaO2 and PaCO2 ) , tcpO2 and tcpCO2 , arterial blood lactic acid on the day of diagnosis and 24 hours after diagnosis.We also selected 10 cured patients as the control group.We analyzed the relationship between these indexes and the prognosis of the sepsis shock patients by statistical software.Results There were significant differences in the arterial blood lactate, tcpO2 and tcpCO2 between the septic shock patients and the control group.There were also significant differences in offset of the pressure of CO2 between tcpCO2 and PaCO2 in septic shock death group and survival group(P<0.05), and the offset of pressure of CO2 was associated with arterial blood lactic acid(R2 =0.538).The offset of pressure of CO2 between tcpCO2 and PaCO2 can predict better outcome of the septic shock patients than the blood lactic acid and APACHEⅡscore.And the ROC curve showed that the use of the pressure CO2 offset between tcpCO2 and PaCO2 0.38 as a cut-off value had a better sensitivity and postitve predictive value.Conclusion The offset of pressure of CO2 between tcpCO2 and PaCO2 can prompt the microcirculation as same as the arterial blood lactate and has a better sensitivity and positive predictive value in predicting outcome of the septic patients, but it needs more clinical researches to confirm.