Acil Servise Başvuran Hıpoperfüze Hastalarda Etco2 Düzeyinin Prognoz Üzerine Etkisi

Abstract

Akçora Z., The Effect of EtCO2 Level on Prognosis in Patients who admitted with hypoperfusion in the Emergency Service, Hacettepe University Faculty of Medicine, Thesis of Emergency Medicine, Ankara 2018. Hypoperfusion is a problem that usually accompanies shock and can be accompanied by severe clinical conditions. In this study, we aimed to study the prognostic role of EtCO2, a non-invasive, inexpensive and simple method, measured by capnography, in patients with impaired perfusion. The study was performed prospectively and observationally on 100 patients. Patients with any of the hypoperfusion criteria were included in the study. Recording was done with the usage of capnography for 1 min in patients with hypoperfusion. The patients’ EtCO2 values were recorded. The patients were followed until any termination (death, discharge, referral) was reached. The fifty three percent of the patients were female and 47% were male. The mean age of the patients was 65 years. 42% of paients had a history of malignancy. Sepsis-septic shock was detected in 44% of the patients. The mean end-tidal CO2 value was calculated as 19,36 ± 5,90 mmHg. When the end tidal CO2 values was analyzed according to the outcome of the patients, the mean value was 16.59 ± 4.83 mmHg in the died patients and 20,95 ± 6,05 mmHg in survived patients. End tidal CO2 values were found to be statistically significantly lower in the died group (p = 0.02). The area under the ROC for end tidal CO2 (AUC) value was calculated as 0.709. The cut-off value for the end tidal CO2 value was calculated to be 20.50 mmHg with the 84.4% sensitivity and 55.7% specificity. The end-tidal carbon dioxide (ETCO2) level measured by capnograph which is a non-invasive, inexpensive and simple method can provide sufficient data on tissue perfusion and prognosis in patients with hypoperfusion in emergency department.