Impact of PCO2 gap protocol application on early postoperative mortality and organ failure in high risk surgical patients undergoing major abdominal surgeries

Abstract

Background: high risk surgical patients undergoing major abdominal surgeries still have higher rate of mortality and organ failure rates in the early postoperative period. Objective: We aimed to assess PCO2 gap protocol application in the intraoperative and early post-operative (first 12 hours) on postoperative mortality and organ failure in high risk surgical patients undergoing major abdominal surgeries compared to a classical goal directed therapy protocol (GDT) targeting mean arterial blood pressure (MAP), mixed venous oxygen saturation (SvO2), central venous pressure (CVP), Haematocrite value (Hct) and urine output (UOP). Patients and Methods: Guided by Shoemacker et al score 80 high risk surgical patients undergoing major abdominal surgeries were divided into two groups group A PCO2 gap algorithm was applied intraoperative and 12 h postoperative end point PCO2 gap 2-6mm Hg ,group B goal directed therapy protocol targeting MAP > 65mmHg, CVP between 8-12cmH2O , Haematocrite value more than 30, Svo2 >75% and urine output more than >0.5 ml/kg/hr an applied intraoperative and 12 postoperative end point . Postoperative organs dysfuctions were assessed using the Sequential Organ Failure Assessment (SOFA) score recorded daily ICU discharge then every three days till discharge home.