Predictive significance of tissue hypoperfusion markers in different shock types in low income countries

The most common condition that brings patients to the medical intensive care unit (MICU) is hemodynamic instability, accompanied by tissue hypoperfusion. In order to make easier and quicker diagnosis of this syndrome marker tissue hypoperfusion is monitored. The aim of this study is to determine the prognostic significance of the level of lactate, lactate clearance, central venous oxygen saturation (ScvO₂) and venous-to-arterial carbon dioxide difference (∆pCO₂) in two time periods in critically ill patients with acute circulatory failure in low income countries. This is a prospective study for a period of 8 months that included all patients with signs of cardiovascular system failure and tissue hypoperfusion. The study included 82 patients with the mean age of 64 years, of which 37% were women. The values of the lactate in surviving patients who had some form of non-septic shock at the zero hour (T₀) were T₀ = 6.31 ± 5.15, and at the sixth hour after reanimation the values (T₆) were T₆ = 3.71 ± 3.62 (p < 0.05), while the lactate levels in the group of non-survivors were T₀ = 6.64 ± 7.55 and T₆ = 9.41 ± 9.51; (p > 0.05). The main conclusion of this study is that the serum lactate concentration in patients who developed some form of non-septic shock has the highest predictive significance compared to the other two markers of tissue hypoperfusion (venous-to-arterial carbon dioxide difference and central venous oxygen saturation).