Chest
Original ResearchCritical Care MedicineCutaneous Ear Lobe Pco2 at 37°C To Evaluate Microperfusion in Patients With Septic Shock
Section snippets
Study Population
The study was conducted between March and November 2008 in a 20-bed ICU of a university hospital after approval by our institutional comité de protection des personnes (No. IRB0006477). Patients were enrolled after written informed consent was obtained from the patient or the next of kin. Forty-six patients ≥ 18 years were studied within 24 h after the onset of septic shock, which was defined according to classic criteria.23 The diagnosis of infection was established by the presence of bacteria
Comparison Between Patients With Septic Shock and Patients in the Control Group
Baseline characteristics of patients with septic shock and patients in the control group are described in Table 1. The baseline levels of Pc-aco2 and Pc-etco2 were significantly higher in patients with septic shock than in patients in the control group: 14.8(12.6) vs 6(2.7) mm Hg and 25(16.3) vs 9(3.8) mm Hg, P < .0001, respectively (Fig 1). The areas under the ROC curve for Pc-aco2 and Pc-etco2 were 0.94 (0.85–0.98) and 0.96 (0.86–0.99), respectively. A threshold of 9 mm Hg for Pc-aco2
Discussion
This study shows four things. First, when measuring at 37° at the ear lobe, a cutoff value of 9 mm Hg for the gradient Pc-aco2 discriminated patients with septic shock from the patients in the control group in the ICU with a sensitivity of 86% and a specificity of 93%. Second, the noninvasive gradient, Pc-etco2, also discriminated patients with septic shock from the patients in the control group in the ICU with a cutoff value of 16 mmHg. Third, in patients with septic shock, the evolution of
Acknowledgments
Author Contributions: Dr Vallée: contributed to collecting the data, performing the statistical analysis, and writing the manuscript.
Dr Mateo: contributed to collecting the data, performing the statistical analysis, and writing the manuscript.
Dr Dubreuil: contributed to collecting the data.
Dr Poussant: contributed to collecting the data.
Dr Tachon: contributed to collecting the data.
Dr Ouanounou: contributed to collecting the data.
Dr Payen: contributed to designing the study and correcting the
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2018, Hemodynamics and Cardiology: Neonatology Questions and ControversiesDeterminants of Transcutaneous Ear Lobe CO<inf>2</inf> Tension (PtCO<inf>2</inf>) at 37°C during On-Pump Cardiac Surgery
2015, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Transcutaneous CO2 tension (PtCO2) measured at the ear lobe level has proven to be a reliable tool for assessing microcirculation in septic patients. The value of the PaCO2-PtCO2 gradient is increased in patients with septic shock, particularly in nonsurvivors.19 Microcirculation perfusion is also an issue in patients under extracorporeal circulation, but few specific monitoring devices have been evaluated in this particular context.
Back to basic physiological questions and consideration of fluids as drugs
2014, British Journal of AnaesthesiaMonitoring the tissue perfusion during hemorrhagic shock and resuscitation: tissue-to-arterial carbon dioxide partial pressure gradient in a pig model
2021, Journal of Translational Medicine
Funding/Support: This study was supported in part by a research grant from the University of Paris 7, Plan Quadriennal Ministère de la Recherche.
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