Skip to main content

Advertisement

Volume 3 Supplement 1

ESICM LIVES 2015

Venoarterial carbon dioxide gradient utility as a criterion for blood transfusion at the intensive care unit

Article metrics

  • 1407 Accesses

Intr

Currently there is controversy about criteria for blood transfusion in critically ill patients by a level of hemoglobin and specially as a strategy to raise the venous oxygen saturation (Sv02).

Objectives

To analyze de utility of the venoarterial carbon dioxide gradient (V-a PC02) to detect those patients who will respond with a rise of Sv02 to blood transfusion.

Methods

Patients within their first 12 hours from admission to the intensive care unit (ICU) during the hemodynamic optimization protocol in which blood transfusion was decided to rise the Sv02 after hemodynamic optimization: central venous pressure (CVP)>8 mmHg, mean arterial pressure (MAP)>65 mmHg, peripheral oxygen saturation (Sp02)>90%. Pre and post transfusion hemoglobin, venous oxygen saturation (Sv02), and V-a PC02 were measured, then divided in two groups: "Responders" (R) if a rise >5%. In Sv02 after transfusion was present and in "Non responders" (NR) with a rise < 5% in Sv02 after transfusion. Receiver Operating Characteristic (ROC) curve analysis was performed to asses the utility of the pre transfusion V-a PC02 as a tool to predict responsiveness of the Sv02 to blood transfusion.

Results

73 patients were analyzed, mean age of 68 ± 2, with 35 (47.9%) males, 25 (34,25%) patients in the R group and 48 (65,75%) in the NR group.

ROC curve analysis were performed resulting in an area under the curve of 0.82 (p < 0.01; CI 0.73-0.91) with a pre transfusion V-a PC02 cutoff value of ≥6 showing a sensibility 66% of and a specificity of 84% for predicting those patients who will not respond with a rise greater than 5% in the post transfusion Sv02.

Conclusions

V-a PC02 >6 mmHg identifies those patients that will no show a rise of the Sv02 as a response to blood transfusion.

Author information

Correspondence to JL Navarro.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Navarro, J., Sanchez-Calzada, A., Gastelum, R. et al. Venoarterial carbon dioxide gradient utility as a criterion for blood transfusion at the intensive care unit. ICMx 3, A221 (2015) doi:10.1186/2197-425X-3-S1-A221

Download citation

Keywords

  • Intensive Care Unit
  • Receiver Operating Characteristic
  • Blood Transfusion
  • Curve Analysis
  • Receiver Operating Characteristic Curve