Evidence map›Paper›PMID 35946659›Full record

SynthesisRevista Brasileira de terapia intensiva

Comparison of central venous minus arterial carbon dioxide pressure to arterial minus central venous oxygen content ratio and lactate levels as predictors of mortality in critically ill patients: a systematic review and meta-analysis.

Arnaldo Dubin, Cecilia Inés Loudet, Francisco Javier Hurtado, Mario Omar Pozo, Daniel Comande, Luz Gibbons, Federico Rodriguez Cairoli, Ariel Bardach

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Revista Brasileira de terapia intensiva. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Arnaldo DubinServiço de Terapia Intensiva, Sanatorio Otamendi - Buenos Aires, Argentina.ORCID 0000-0002-3349-5447
Cecilia Inés LoudetIntensive Care Service, Hospital Interzonal de Agudos General San Martín - La Plata, Argentina.ORCID 0000-0002-1647-5110
Francisco Javier HurtadoServiço de Terapia Intensiva, Hospital Español - ASSE - Montevideo, Uruguay.ORCID 0000-0002-2570-5467
Mario Omar PozoServiço de Terapia Intensiva, Hospital Británico - Buenos Aires, Argentina.ORCID 0000-0002-0809-8087
Daniel ComandeCentro de Investigación de Epidemiología y Salud Pública - Buenos Aires, Argentina.ORCID 0000-0002-7111-5169
Luz GibbonsCentro de Investigación de Epidemiología y Salud Pública - Buenos Aires, Argentina.ORCID 0000-0002-0235-1635
Federico Rodriguez CairoliCentro de Investigación de Epidemiología y Salud Pública - Buenos Aires, Argentina.ORCID 0000-0002-3029-4439
Ariel BardachInstituto de Efectividad Clínica y Sanitaria - Buenos Aires, Argentina.ORCID 0000-0003-4437-0073

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe central venousarterial carbon dioxide pressure to arterial-central venous oxygen content ratio (Pcv-aCO2/Ca-cvO2) is frequently used as a surrogate for tissue oxygenation. We aimed to identify and synthesize literature and quality of evidence supporting Pcv-aCO2/Ca-cvO2 as a predictor of mortality in critically ill patients compared with lactate.

methodsWe searched several databases for studies measuring Pcv-aCO2/Ca-cvO2 in critically ill patients. Independent investigators performed the article screening and data extraction. A random-effects metaanalysis was performed. Pooled standardized mean differences (SMD) were used to compare the prognostic ability of Pcv-aCO2/Ca-cvO2 and lactate.

resultsWe initially retrieved 172 studies; 17 were included for qualitative description, and 10 were included for quantitative synthesis. The mean Pcv-aCO2/Ca-cvO2 was higher in nonsurvivors than in survivors (pooled SMD = 0.75; 95%CI 0.34 - 1.17; I2 = 83%), as was the case with lactate levels (pooled SMD = 0.94; 95%CI 0.34 - 1.54; I2 = 92%). Both tests were statistically significant predictors of mortality, albeit with overlapping 95%CIs between them.

conclusionModerate-quality evidence showed little or no difference in the ability of Pcv-aCO2/Ca-cvO2, compared with lactate, to predict mortality. Nevertheless, our conclusions are limited by the considerable heterogeneity among the studies.PROSPERO registration: CRD42019130387.

Indexed as

Carbon DioxideShock, SepticCritical IllnessHumansLactic AcidOxygenCarbon DioxideLactic AcidOxygen

Identifiers

PMID35946659
PMCPMC9354115

What OpenQuestion holds

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Registered trials

None linked

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.