الفهرس 
Title : CO2 gap changes compared to cardiac output changes measured by pulse contour or transthoracic echocardiography in response to intravenous volume expansion or vasopressor therapy in septic shock patients
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Abstract
Background. The arteriovenous difference of partial pressure of carbon dioxide (PCO2) between mixed or central venous blood and arterial blood is the ∆PCO2 or CO2 gap. Previous data demonstrated a strong relationship between ∆PCO2 and cardiac index at the very early phase of resuscitation in septic shock. Monitoring the ∆PCO2 from the beginning of the resuscitation may be a useful tool to assess the adequacy of cardiac output in tissue perfusion.
Objectives: Our aim of the study is to investigate the value of PCO2 gap changes in the early septic shock management compared to the cardiac output.
Methods. Seventy-six patients with diagnosis of septic shock admitted to critical care department, Cairo university hospitals were included up on admission to ICU and after insertion of invasive lines (T0). The 2nd set of measurements (T1) were taken after completion of the initial resuscitation when a stable MAP by a fluid boluses of up to 30 ml/kg iv and/or by vasopressor infusion or after 3 hours which is closer. Then, patients were classified according to initial ∆PCO2, resuscitation response, and 28-days mortality into high gap (Pcv-aCO2 > 6 mmHg)/normal gap (Pcv-aCO2 ≤6 mmHg), responsive (15% increase in CI or stable MAP was achieved)/non-responsive (< 15% increase in CI or a stable MAP was not achieved) and survivors/non-survivors respectively. The response/non-response to initial resuscitation and ICU morbidity/ recovery rate was the study primary outcome while secondary outcomes included ICU length of stay (LOS) and 28-day ICU Mortality.