P0570 / #306: CORRELATION BETWEEN VENOUS-ARTERIAL CO2 DIFFERENCE AND MYOCARDIAL DYSFUNCTION IN CHILDREN WITH SEPSIS

Abstract

Aims & Objectives: To determine the association between venous-arterial CO2 difference (Pv-aCO2) and clinical outcomes of interest in children with severe sepsis and septic shock Methods: Design: analytical observational study of a prospective cohort. Setting: It was carried out from January 2015 to January 2018 in the pediatric intensive care unit of a referral hospital. Materials and methods: Of a total of 1.159 patients who were admitted to pediatric critical care, 375 had severe sepsis and septic shock, of which 67 fulfilled the inclusion criteria. Arterial and venous gases were drawn simultaneously with a transthoracic echocardiogram, Pv-aCO2 and other measures of tissue perfusion such as arterial lactate, venous as well as evolution to multiple organ failure. Results: Half of the patients were under 24 months old, with a slight predominance of males (53.7%). The main site of infection was the lungs in 56% of the cases, with a 91.2% survival rate. The patients who died had a higher venous lactate level (IQR 16.2-33.6 p=0.02). There was no correlation between myocardial dysfunction seen on echocardiogram and a Pv-aCO2 greater than 6 in children with severe sepsis and septic shock (r=0.13). Pv-aCO2 as well as central venous saturation have low sensitivity to detect multiple organ failure and a poor correlation with the number of compromised systems (r = 0.08). Conclusions: The delta CO2 is not associated with myocardial dysfunction measured by echocardiogram in children with severe sepsis and septic shock. It also does not correlate with the number of organs involved and mortality.