COMPARSION OF BLOOD GAS DIFFERENCE (OXYGEN AND CARBON DIOXIDE LEVELS ) WITH BLOOD LACTATE CLEARANCE IN CRITICALLY ILL PATIENTS ADMITTED IN INTENSIVE CARE UNIT.
- Conditions
- Other disorder of circulatory system,
- Registration Number
- CTRI/2021/08/035506
- Lead Sponsor
- Dr Ram Manohar Lohia Institute of Medical Sciences
- Brief Summary
Aims and objectives
The present study is aimed to evaluate
1.The relationship between the P(cv-a)CO2/D(a-cv)O2 ratio and LC for 8 and 24 hours and
2. To define a cutoff value for the P(cv-a)CO2/D(a-cv)O2 ratio to identify an 8 and 24-hour LC at 10% and 20% respectively after resuscitation
Research question
Venous-to-arterial PCO2 /arterial-venous O2 content difference and to find a correlation of the above with lactate clearance in septic shock patients.
MATERIALS AND METHODS:
The global hemodynamic, arterial, and central venous blood gas analyses will be simultaneously performed on the T0, T8, T24 (in hours)
The position of the tip of the central venous catheter in the upper part of the right atrium will be confirmed on chest radiograph before sampling
Blood gas samples will be taken anaerobically in 3-mL heparinized syringes and analyzed for blood gas and the same blood gas machines will be used to analyze the arterial and central venous blood gas samples
The pairs of arterial and central venous blood samples were withdrawn simultaneously for determination of the following variables:
PaO2
PaCO2
Central venous oxygen tension (PcvO2)
Central venous carbon dioxide tension (PcvCO2) and SaO2
The Hb and lactate level will be measured from the arterial blood
The arterial oxygen content (CaO2), central venous oxygen content (CvO2), arterio venous oxygen content difference C(a-cv)O2,
veno arterial CO2 tension difference P(cv-a)CO2 ,
P(cv-a)CO2/C(a-cv)O2 ratio, lactate clearance rate (LC)
Lactate clearance and survival will be defined as follows:
CaO2 = (1.34 × SaO2 × Hb) + (0.003 × PaO2)
CvO2 = (1.34 × SvO2 × Hb) + (0.003 × PvO2)
C(a-cv)O2 = CaO2 - CvO2
P(cv-a)CO2 = PvCO2 - PaCO2
P(cv-a)CO2/C(a-cv)O2 ratio = (PcvCO2-PaCO2)/(CaO2 - CvO2)
LC8 rate = (T0 lactate –T8 lactate)/(T0 lactate) × 100%
LC24 rate = (T0 lactate –T24 lactate)/(T0 lactate) × 100%
LC rate =10%from T0 toT8(hrs)
LCrate= 20%fromT0toT24(hrs)
Lactate clearance and survival will be defined as follows:
CaO2 = (1.34 × SaO2 × Hb) + (0.003 × PaO2)
CvO2 = (1.34 × SvO2 × Hb) + (0.003 × PvO2)
C(a-cv)O2 = CaO2 -CvO2
P(cv-a)CO2 = PvCO2 - PaCO2
P(cv-a)CO2/C(a-cv)O2 ratio = (PvCO2 -PaCO2)/(CaO2 -CvO2)
LC8 rate = (T0 lactate –T8 lactate)/(T0 lactate) × 100%
LC24 rate = (T0 lactate –T24 lactate)/(T0 lactate) × 100%
LC rate= 10%fromT0 toT8(hrs)
LCrate= 20%fromT0toT24(hrs)
4 groups
1.LC 8A (>10%)
2.LC 8B(<10%)
3.LC 24A(>20%)
4.LC 24B(<20%)
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- All
- Target Recruitment
- 100
- Patients in septic shock 2.
- Consent for participation from guardian 3.
- Patients with central venous line insitu.
- Declined consent from the guardian 2.
- Pregnant patient 3.
- Patients with pre existing liver or kidney disease 4.
- Patients with incomplete data.
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method The relationship between the P(cv-a)CO2/D(a-cv)O2 ratio and lactate clearance The relationship between the P(cv-a)CO2/D(a-cv)O2 ratio and lactate clearance at baseline, 8 hours and 24 hours.
- Secondary Outcome Measures
Name Time Method To define a cut offvalue for the P(cv-a)CO2/D(a-cv)O2 ratio to identify lactate clearance at 8 & 24 hrs respectively after resuscitation 8 hrs and 24 hrs
Trial Locations
- Locations (1)
Dr.RMLIMS
🇮🇳Lucknow, UTTAR PRADESH, India
Dr.RMLIMS🇮🇳Lucknow, UTTAR PRADESH, IndiaDr Deepak MalviyaPrincipal investigator8176007063drdm58@gmail.com