Arterial to end-tidal carbon dioxide tension difference (CO2gap) as a prognostic marker for adverse outcomes in emergency department patients presenting with suspected sepsis
- Resource Type
- Authors
- Kim Hanna; Kristian Adams; Selwyn Selvedran; Sebastian Sparenberg; Amith Shetty; Jonathan R. Iredell; Benjamin Tang
- Source
- Emergency Medicine Australasia. 30:794-801
- Subject
- medicine.medical_specialty
Respiratory distress
Receiver operating characteristic
business.industry
Dead space
030208 emergency & critical care medicine
Emergency department
medicine.disease
Intensive care unit
Confidence interval
law.invention
Sepsis
03 medical and health sciences
0302 clinical medicine
law
Internal medicine
Emergency Medicine
Cardiology
Medicine
030212 general & internal medicine
business
Adverse effect
- Language
- ISSN
- 1742-6731
OBJECTIVE The arterial to end-tidal carbon dioxide tension difference (CO2 gap) correlates with physiologic dead space. The prognostic value of increased CO2 gap in trauma and respiratory distress patients is documented. Transpulmonary arteriovenous shunting is identified as a predictor of mortality in non-pulmonary sepsis. We set out to investigate the prognostic value of the CO2 gap in a pilot study of patients with suspected sepsis from non-respiratory causes. METHODS Patients presenting to tertiary Australian ED with suspected sepsis (n = 215) underwent near-simultaneous end-tidal carbon dioxide and partial pressure of carbon dioxide measurements. We investigated the correlation of CO2 gap levels with the primary outcome of in-hospital mortality (IHM) and secondary outcomes of sepsis (ΔSOFA ≥2) and IHM and/or intensive care unit stay ≥72 h (IHM/ICU72h) in patients with sepsis because of non-respiratory causes. RESULTS Among patients included in the analysis (n = 165), the CO2 gap showed modest positive correlation with qSOFA (ρ = 0.39) and weak positive correlation with SOFA scores (ρ = 0.29) (both P