Clinical trial NCT06326762: Gap CO2 in Septic Patient to Predict Cardiomyopathy Septic
Official title: Gap CO2 in Septic Patient to Predict Cardiomyopathy Septic
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Gap co2
Cardiac Output, Low
Cardiac Defect
Keywords: cardiac
CO2
septic
Lead sponsor: Mohammed VI University Hospital
Sponsor class: OTHER
First posted: 2024-03-22
Enrollment: 98
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: We included patients diagnosed with sepsis/septic shock admitted at various points in time to the intensive care units of the Mohammed VI University Hospital in Oujda.

Brief summary: the investigators included 98 patients admitted for sepsis and septic shock (68.4% men, 31.6% women) with an average age of 60.42 years ± 15.13, ranging from 21 to 96 years. The average length of hospital stay was 7.53 days. The most noted medical histories were diabetes (38.8%), hypertension (28.6%), and renal insufficiency (17.1%). Regarding laboratory findings: the mean white blood cell count was 15,985.16 cells/mm³, the mean C-reactive protein (CRP) level was 227.69 mg/L, and the mean procalcitonin level was 50.43 µg/L. In terms of blood gas analysis: the mean lactate level was 3.67 mmol/L, and the mean PCO2 gap (DELTAPCO2) was 4.85. All our patients were continuously monitored by pulse wave analysis: the mean cardiac output was 5.69 L/min, and the mean cardiac index was 4.14 L/s/m² All our patients underwent an echocardiogram, which is a routine examination in our department and is performed at the patient's bedside. The average left ventricular ejection fraction (LVEF) was 51.73%, and the average subaortic peak velocity (ITV) was 14.66 cm.

Subsequently. the investigators examined the clinical and paraclinical profile of patients with septic cardiomyopathy. the investigators identified 19 patients with this condition, while 79 patients did not exhibit cardiac involvement. The percentage was significantly higher in the population with cardiac involvement, accounting for 28.3%. Among the patients with cardiac involvement, 76.5% had a PCO2 gap (DELTAPCO2) ≥ 6 mmHg, a significantly reduced cardiac output with an average of 3.3 L/min, and a predominantly low cardiac index, with 64.3% having an index \< 2.2 L/min/m². The mortality rate was significantly increased at 73.7%.


Eligibility criteria: Inclusion Criteria:

* Patients admitted to the intensive care unit
* sepsis or septic shock
* at least one echocardiogram and were monitored by pulse wave contour analysis
* stay of 72 hours in the intensive care unit

Exclusion Criteria:

* Patients without sepsis or septic shock.
* Patients with COVID-19.
* Patients who died within 48 hours of hospitalization.
* Cases with incomplete medical records or patients not monitored.
* Patient with pre-existing cardiac conditions.
* post-operative patients from cardiac and thoracic surgeries.

Primary outcomes:
measure: gapCO2
timeFrame: 10 mounths
Secondary outcomes:
Other outcomes:
Locations:
city: Berkane
country: Morocco
facility: younes Oujidi
Study officials:
References: