[Predictivity associated with oxygen-transporting hemodynamic parameters: relation between the cardiac index and oxygen extraction].
OBJECTIVE
To verify the predictivity of a diagram with the cardiac index (CI) on the y-axis and the oxygen extraction (O2ER) on the x-axis and to verify if the haemodynamic therapy could change the outcome.


METHODS
A retrospective study on a consecutive series of patients.


METHODS
University Intensive Care Unit of Ancona.


METHODS
65 critically ill patients, subdivided in survivors (38) and non survivors (27).


METHODS
All the patients have been monitored with a Swan-Ganz catheter.


METHODS
CI and O2ER at the admission (T0), at 12 (T1), 24 (T2) and 48 hours (T3) from T0. The diagram CI/02ER has been subdivided in 9 parts on the basis of the normal values of CI (> or = 2,5 and < or = 3,5 1/min/m2) and of O2ER (< or = 24 and > or = 28%).


RESULTS
At T2 most of survivors (73.7%) is on the most favourable part of the diagram, with the CI and the O2ER normal or increased, while only 21.4% of non survivors is in this part. On the contrary only 26.3% of survivors versus 78.6% of non survivors are in the less favourable part of the diagram. The chi 2-test shows a good significantly (p = 0.003) in the different distribution on the diagram between survivors and non survivors. A 2 x 2 table has been made. We found: sensibility 78.6% specificity 73.7% and total correct 75.4%. In any other time it has been found a significant different distribution on the diagram between survivors and non survivors.


CONCLUSIONS
This diagram can be useful to predict the short term outcome in non septic patients, because at 24 hours give a correct prediction of the outcome in 3 patients on 4, with a good prediction either of the good outcome or of the exitus.
Donati
A
A
Istituto delle Emergenze Medico-Chirurgiche, Università degli Studi di Ancona, Ospedale Regionable Torrette, Tornette di Ancona (AN).
Cola
L
L
Danieli
R
R
Adrario
E
E
Givoannini
C
C
Pietropaoli
P
P
D001830:Body Surface Area; D002302:Cardiac Output; D016638:Critical Illness / Q000401:mortality*; D006439:Hemodynamics; D006801:Humans; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D010100:Oxygen