Abstract
Objectives: High risk surgical patients are prone to experience complicated outcomes that directly lead to longer days on ventilators and consequently longer ICU and hospital stay. PCO2 gap has elicited an increasing interest in directing resuscitation towards optimizing CO2 gap. Thus, we aimed to compare the impact of PCO2 gap targeting protocol to a classical Goal Directed Therapy Protocol (GDT) on ICU stay Ventilator day and length of hospital stay, in high-risk surgical patients admitted to ICU. Design: Blinded prospective randomized clinical trial. Settings: Qena University Hospital. Patients: 80 patients who have high risk surgical criteria adopted from Shoemacker et al score and were admitted to ICU postoperatively, were divided into two groups: in group (A) PCO2 gap algorithm was applied 12 h postoperative with end point PCO2 gap 2-6 mm Hg ,and in group (B) goal directed therapy protocolwas applied 12 postoperative targeting endpoints: MAP >65mmHg, CVP between 8-12 cmH2O, Haematocrite value more than 30, SvO2 >75% and urine output more than >0.5 ml/kg/hr. Measurements and results: Regarding duration of ventilator dependency, ICU stay and hospital stay, all values were lower in group a compared to group B although it was statistically insignificant. Conclusion: In high risk surgical patients in ICU, targeting PCO2 values has no significant difference to early goal directed therapy regarding the decrease in ventilation days, ICU stay or hospital stay.
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