Comparison of Transcutaneous and Arterial Blood Gas Analyses in Patients with Sepsis and Septic Shock

Abstract

Objective: This study aims to compare the effectiveness of non-invasive pressure of transcutaneous CO 2 (PtcCO 2 ) and O 2 (PtcO 2 ) analyzers versus conventional blood gas sampling in patients with sepsis and septic shock. Materials and Methods: Sepsis patients without a need for inotrope support (sepsis) were prospectively enrolled to group 1 (n=50), whereas group 2 (n=50) was composed of patients needing inotropes (septic shock). Demographic data, laboratory tests, Acute Physiology and Chronic Health Evaluation-II (APACHE-II) and Sequential Organ Failure Assessment (SOFA) scores, standard monitoring data, data of blood gas analysis (pH, PaCO 2 , PaO 2 , and SaO 2 ), and transcutaneous CO 2 and O 2 were collected at the first, second, third, and fourth hours. Results: No significant difference was noted between the groups in terms of demographic parameters, baseline white blood cell, hematocrit, baseline heart rate, central venous pressure, respiratory rate, and positive end-expiratory pressure values. Group 2 had significantly higher serum urea and creatinine levels and lower albumin levels and mean arterial pressure, whereas group 1 had significantly lower APACHE-II and SOFA scores and peak inspiratory pressure and FiO 2 . No significant difference was noted between the PtcCO 2 and PaCO 2 values in group 1, whereas the PtcCO 2 values of group 2 were significantly lower than PaCO 2 . PtcO 2 and PaO 2 values were significantly lower in group 1, whereas PtcO 2 vs PaO 2 values were significantly lower in group 2. A strong correlation was noted between arterial and transcutaneous CO 2 and O 2 values in both the groups. Conclusion: PtcCO 2 assessment may be an alternative method in patients with sepsis but not in septic shock. PtcO 2 measurement may not be a reliable method for patients with sepsis and septic shock. Keywords: Sepsis, septic shock, ICU, transcutaneous CO 2 , transcutaneous O 2 , arterial blood gas analysis ÖZ Amaç: Sepsisli ve septik şoklu hastalarda non-invaziv transkutanöz parsiyel CO 2 (PtcCO 2 ) ve O 2 (PtcO 2 ) basıncı analizörlerininin etkinliğini geleneksel kan arter kan gazı analizi ile karşılaştırmayı amaçladık. Gereç ve Yöntem: Sepsis 3 tanı kriterlerine göre "sepsis" tanısı alan hastalar grup 1'e (n=50), "septik şok" tanısı alan hastalar grup 2'ye (n=50) ayrıldı. Demografik veriler, laboratuvar testleri, Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi-II (APACHE-II) ve Ardışık Organ Yetersizliği Değerlendirme (SOFA) skorları, 1., 2., 3., ve 4. saatlerdeki standart monitorizasyon verileri, kan gazı analizi verileri (pH, PaCO 2 , PaO 2 , SaO 2 ) ve transkutanöz CO 2 ve O 2 değerleri kaydedildi. Bulgular: Gruplar arasında demografik parametreler, başlangıç beyaz küre, hematokrit, kalp hızı, santral venöz basınç, solunum sayısı ve pozitif ekspirasyon-sonu basınç değerleri açısından anlamlı bir fark bulunamadı. Grup 2'de serum üre ve kreatinin seviyeleri belirgin olarak yüksekken, albümin seviyeleri, ortalama arteriyel basınç daha düşüktü. APACHE-II ve SOFA skorları, tepe inspiratuar basınç ve...