Table of Contents Author Guidelines Submit a Manuscript
Anesthesiology Research and Practice
Volume 2011, Article ID 759792, 8 pages
http://dx.doi.org/10.1155/2011/759792
Clinical Study

A large Venous-Arterial PCO2 Is Associated with Poor Outcomes in Surgical Patients

1Anestesiologia e Cuidados Intensivos, Hospital do Servidor Público Estadual, 04039-901 São Paulo, SP, Brazil
2De Terapia Intensiva, Hospital do Servidor Público Estadual, 04039-901 São Paulo, SP, Brazil
3Anestesiologia, Hospital do Servidor Público Estadual, 04039-901 São Paulo, SP, Brazil
4De Terapia Intensiva, Hospital das Clínicas, 05403-900 São Paulo, SP, Brazil

Received 23 May 2011; Revised 31 July 2011; Accepted 4 August 2011

Academic Editor: William McBride

Copyright © 2011 João M. Silva et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. This study evaluated whether large venous-arterial CO2 gap (PCO2 gap) preoperatively is associated to poor outcome. Method. Prospective study which included adult high-risk surgical patients. The patients were pooled into two groups: wide [P(v-a)CO2] versus narrow [P(v-a)CO2]. In order to determine the best value to discriminate hospital mortality, it was applied a ROC (receiver operating characteristic) curve for the [P(v-a)CO2] values collected preoperatively, and the most accurate value was chosen as cut-off to define the groups. Results. The study included 66 patients. The [P(v-a)CO2] value preoperatively that best discriminated hospital mortality was 5.0 mmHg, . Preoperative patients with [P(v-a)CO2] more than 5.0 mmHg presented a higher hospital mortality (36.4% versus 4.5%  ), higher prevalence of circulatory shock (56.8% versus 22.7%  ) and acute renal failure postoperatively (27.3% versus 4.5%  ), and longer hospital length of stays 20.0 (14.0–30.0) versus 13.5 (9.0–25.0) days . Conclusions. The PCO2 gap values more than 5.0 mmHg preoperatively were associated with worse postoperatively outcome.