Central Venous and Arterial Gases Level Versus Lactate Clearance as an Indicator of Initial Resuscitation in Septic Patients in Intensive Care Unit

Objective: Aim of this study was to compare the central venoarterial carbon dioxide difference/arterial-central venous oxygen difference (P(va)CO2/C(a-v)O2) ratio versus lactate clearance as an indicator to evaluate the steps of initial resuscitation in septic patients.

Patients and Method: Our study was conducted in the ICU,Minia University Hospital. Eighty patients with severe sepsis or septic shock

Results: There was improvement in CVP, MAP, or Scvo2 at T8 after early resuscitation with no significant differences between group 1 and group 2 and inside each group. There were no significant difference in P(v-a)CO2/C(a-v)O2 ratio at T0 and at T8 at group 1. However there was higher lactate level at T0 and exhibited significantly lower at T8 in group 2.

Conclusion: Further clinical trials are needed to conclusively establish lactate clearance as a resuscitation endpoint and an outcome measure to be targeted during the most proximal phases of severe sepsis and septic shock.