ArticleIntensive care medicine2008
Central venous-to-arterial carbon dioxide difference: an additional target for goal-directed therapy in septic shock?
Article in Intensive care medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 105 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Transcutaneous-Arterial Carbon Dioxide Gradient Predicts Microcirculatory Dysfunction And The Development of Organ Failure After Cardiac Surgery
Early Goal Directed Therapy Using a Physiological Holistic View. A Multicenter Study in Latin America: The ANDROMEDA-SHOCK Study
Peripheral Perfusion Versus Lactate Targeted Fluid Resuscitation in Septic Shock: ANDROMEDA-SHOCK PHYSIOLOGY STUDY
Veno-arterial Carbon Dioxide Partial Pressure Difference (CO2gap) for Early Resuscitation of Septic Shock: A Multicenter Prospective Randomized Trial (CARBON)
Who cites it
105 citing papers in PubMed, 271 citations in OpenAlex.
- Efficacy and Safety of Esmolol in Treatment of Patients with Septic Shock.Chinese medical journal · 2016Trial
- Central venous O₂ saturation and venous-to-arterial CO₂ difference as complementary tools for goal-directed therapy during high-risk surgery.Critical care (London, England) · 2010Trial
- Gastric tonometry versus cardiac index as resuscitation goals in septic shock: a multicenter, randomized, controlled trial.Critical care (London, England) · 2009Trial
- Article
- Renal Veno-Arterial Carbon Dioxide Gap Fails to Detect Renal Medulla Microcirculatory Changes in a Large Animal Model of Sepsis-Associated Acute Kidney Injury.Shock (Augusta, Ga.) · 2026Article
- Early detection of microcirculatory changes using simultaneous heated and unheated transcutaneous blood gas monitoring: a proof-of-concept study in a porcine lipopolysaccharide model of systemic inflammation.Frontiers in medicine · 2026Article
- Central Venous-arterial Carbon Dioxide Difference (pCOIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Incidence, severity, and predictors of citrate accumulation during continuous kidney replacement therapy in the critically ill.Critical care (London, England) · 2025Article
- Jugular bulb venous to arterial carbon dioxide gradient is associated with treatment-responsive phenotypes of hypoxic-ischemic brain injury.Resuscitation plus · 2025Article
- Use of COAnnals of intensive care · 2025Review
- Regional venous-to-arterial carbon dioxide pressure and content differences during endotoxemic shock: influence of hydrogen ion accumulation vs. Haldane effect.Intensive care medicine experimental · 2025Article
- COJournal of clinical medicine · 2025Article
- Veno-Arterial Partial Pressure of Carbon Dioxide Difference as a Metric of Systemic Oxygen Delivery: Insights from a Correlative Meta-Analysis.Journal of pediatric intensive care · 2024Article
- Changes in central venous-to-arterial PCOCritical care (London, England) · 2024Article
- Effects of volume management on free flap perfusion and metabolism in a large animal model study.Lab animal · 2024Article
- The Evolution of Central Venous-to-arterial Carbon Dioxide Difference (PCOIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Venoarterial Partial Pressure of Carbon Dioxide Difference: Let's Trend It!Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- COThe Southern African journal of critical care : the official journal of the Critical Care Society · 2024Article
- Venous Minus Arterial Carbon Dioxide Gradients in the Monitoring of Tissue Perfusion and Oxygenation: A Narrative Review.Medicina (Kaunas, Lithuania) · 2023Review
- [Correlation between the shock index and the anaerobic index].Revista medica del Instituto Mexicano del Seguro Social · 2023Observational
45 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo test the hypothesis that, in resuscitated septic shock patients, central venous-to-arterial carbon dioxide difference [P(cv-a)CO(2)] may serve as a global index of tissue perfusion when the central venous oxygen saturation (ScvO(2)) goal value has already been reached.
designProspective observational study.
settingA 22-bed intensive care unit (ICU). PATIENTS: After early resuscitation in the emergency unit, 50 consecutive septic shock patients with ScvO(2) > 70% were included immediately after their admission into the ICU (T0). Patients were separated in Low P(cv-a)CO(2) group (Low gap; n = 26) and High P(cv-a)CO(2) group (High gap; n = 24) according to a threshold of 6 mmHg at T0. MEASUREMENTS: Measurements were performed every 6 h over 12 h (T0, T6, T12).
resultsAt T0, there was a significant difference between Low gap patients and High gap patients for cardiac index (CI) (4.3 +/- 1.6 vs. 2.7 +/- 0.8 l/min/m(2), P < 0.0001) but not for ScvO(2) values (78 +/- 5 vs. 75 +/- 5%, P = 0.07). From T0 to T12, the clearance of lactate was significantly larger for the Low gap group than for the High gap group (P < 0.05) as well as the decrease of SOFA score at T24 (P < 0.01). At T0, T6 and T12, CI and P(cv-a)CO(2) values were inversely correlated (P < 0.0001).
conclusionIn ICU-resuscitated patients, targeting only ScvO(2) may not be sufficient to guide therapy. When the 70% ScvO(2) goal-value is reached, the presence of a P(cv-a)CO(2) larger than 6 mmHg might be a useful tool to identify patients who still remain inadequately resuscitated.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.