Diferencia veno-arterial de dióxido de carbono como predictor de mortalidad en pacientes en estado de shock, en la terapia intensiva pediátrica del hospital de niños "Robert Gilbert Elizalde", marzo-agosto 2020.

Abstract

Background: Shock is common in Pediatric Intensive Care Units (PICU) where it constitutes a real health problem due to its high mortality (46%), which is why early detection and intervention is essential; Through the use of diagnostic tools for early detection of tissue hypoperfusion. Objectives: To evaluate the usefulness of the veno-arterial carbon dioxide difference as a predictor of mortality in shock patients admitted to the PICU of the Dr. Roberto Gilbert Elizalde Children's Hospital. Materials and Methods: It is an observational, prospective and cross-sectional study, a series of cases was obtained through surveillance in a period of six months (March 1 to August 31, 2020) in patients older than 1 month up to 17 years who were admitted to the PICU at the HRGE. Results: 97 patients with shock were detected, 84 met the inclusion and exclusion criteria equivalent to 86.6% of the universe. A mortality of 10.7% was evidenced, the highest number of deaths occurred in the age group of children under one year, with 5 cases representing 16.1%. The most frequent shock was distributive with 68 cases of which 10.3% died. The ΔCO2 of more than 6 mm / Hg has a higher probability of dying, the test showed 88% sensitivity, with an area under the ROC curve of 0.84. Conclusions: ΔPCO2 greater than 6 mm / Hg is an adequate parameter to assess tissue perfusion in patients with shock. But it is recommended to combine it with other tissue hypoperfusion parameters since at the moment none by itself has proven to be 100% effective.