Valor pronóstico del índice de saturación tisular de oxígeno (rso2) como expresión de la oxigenación tisular en pacientes con sepsis secundaria a neumonia adquirida en la comunidad.

Identificador:  TDX:2582

Handle: https://hdl.handle.net/20.500.11797/TDX2582

Autors:  Claverias Cabrera, Laura

Resum:
Introduction: community-acquired pneumonia is an alveolar infection. Despite progress it still represents an important cause of morbidity and mortality in the world. It is important to find a way to early detect the group of patients that presents worse prognostic. In this context, our investigation has evaluated tisular oxigenation as an indirect indicator of microcirculation’s state which can early detect patients at risk of presenting complications. Methods: we included patients admitted to the ICU with the diagnostic of community-acquired pneumonia. Measurements of regional oxygen saturation index (rSO2) were taken using near-infrared spectroscopy technology. The association between this variable and other classical hemodynamic variables and their predictive value for mortality were determined. Results: presence of low rSO2 value was associated with greater mortality. This variables showed better predictive power for mortality than the ones obtained with a vascular occlusion test (AUROC 0.790, IC 95% 0.637-0.943, p=0.004). The presence of low rSO2 at admission and 24 hours after were the only variables that were independently associated with mortality (HR 8.99, IC 95% 1.05-76.8, p=0,045 i HR 13.18, IC 95% 1.52-113.6, p=0.019, respectively). Conclusions: determination of rSO2 can identify which patients with respiratory sepsis present greater severity earlier than other hemodynamical variables.