Hubungan Rasio P(v-a)CO2/C(a-v)O2 terhadap Lactate Clearance sebagai Penanda Keberhasilan One Hour Bundle pada Pasien Sepsis di ICU RSUP. H Adam Malik

Abstract

Background In sepsis, there is reduced tissue perfusion and causes multiple organ failure. This causes an imbalance between oxygen supply and demand, resulting in tissue hypoxia. So a marker is needed to assess tissue perfusion disorders. The P(v- a)C02/C(a-v)02 ratio reflects the lactate level, and lactate clearance. Methods This study used an analytic research design with a prospective cohort study design, which aimed to determine the relationship between the ratio of P(v- a)C02/C(a-v)02 to Lactate Clearance in the success of one hour bundle in sepsis patients treated in the ICU. Assessment will be made at T0 (sepsis established) and Tl (6 hours after sepsis treatment was given). Results The mean of Lactate (T0) was 22.06 mmol/L median l6.85 mmol/L. P(v- a)C02 (T0) the mean was 9.28 mmHg median 8,50 mmHg; P(v-a)C02 / C(a-v)02 ratio obtained mean of 3.66 median 3,56. Lactate (Tl) with mean of l2.52 mmol/L median 9,00 mmol/L, in P(v-a)C02 (Tl) obtained mean of 8.50 mmHg median 7,50 mmHg. P(v-a)C02 / C(a-v)02 the mean was 3.45 median 2,57. Lactate clearance the mean was 48,29%. Bivariate analysis in this study between lactate clearance and the ratio of P(v-a)C02 / C(a-v)02 obtained a P value of 0.009. spearmen correlation value -0.052 which means it has a strong relationship with a negative correlation between the two variables. Conclusion There is a significant relationship between the ratio of P(v-a)C02/C(a- v)02 to Lactate Clearance in the success of one hour bundle in sepsis patients