Valor pronóstico del índice PvaCO2/CavO2 y el Lactato en paciente con sepsis en las unidades de cuidado intensivo del Hospital MEDERI, septiembre de 2020- septiembre de 2021

Sepsis and septic shock are a major health problem, mortality is very high, and the main cause of AKI. Early identification of tissue hypoperfusion is key in the treatment of patients with sepsis. Lactate is currently used to assess tissue hypoperfusion with many limitations, additional markers such as PvaCO2/CavO2 are being explored. Materials and methods: Observational study of a retrospective cohort, including patients older than 18 years with a diagnosis of sepsis and/or septic shock treated in the ICU for one year. The prognostic value of lactate and PavCo2/CavO2 index at the time of diagnosis is described. of sepsis and 24 hours, associated with the clinical variables of admission and at 48 hours, and its relationship with mortality at 28 days. A bivariate analysis of the variables of importance was performed. Results: The study patients (207) had high rates of SOFA (10 points) and APACHE (26 points), septic shock 86%, COVID 82.6%, and acute kidney injury at admission in 53% and at 48 hours 56% of patients. Within 48 hours, 23.16% of the patients died, with a 28-day mortality of 97.1%. Lactate and PavCo2/CavO2 on average were below hypoperfusion values. Conclusion: Kidney injury at 48 hours is associated with higher mortality at 28 days. COVID patients had greater alterations in gas exchange. Lactate and PavCo2/CavO2 were not found to correlate in patients with sepsis.