Predicting mortality risk in severe ards patients using indirect calorimetry-based oxygen consumption and carbon dioxide production rates
10.3760/cma.j.issn.1671-0282.2025.03.017
- VernacularTitle:基于间接测热法的耗氧量与二氧化碳生成量对重度ARDS患者死亡风险的预测研究
- Author:
Ke GUAN
1
;
Huihuang ZOU
;
Yuna HU
;
Ling YE
;
Yanwei CHENG
;
Jingjing NIU
;
Cunzhen WANG
;
Ke QIN
;
Tingyuan ZHANG
;
Bin YANG
;
Yuhan SUN
;
Wenliang ZHU
;
Qingbo FAN
;
Zhisong GUO
;
Yongchun CHEN
;
Wenjie WANG
Author Information
1. 河南省人民医院，郑州大学人民医院，河南大学人民医院营养科，郑州 450003
- Keywords:
Severe ARDS;
Indirect calorimetry;
Oxygen consumption;
Carbon dioxide production
- From:
Chinese Journal of Emergency Medicine
2025;34(3):396-403
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between oxygen consumption (VO 2), carbon dioxide production (VCO 2), and Oxygen Consumption/lactate (VO 2/Lac) with risk of death in patients with severe ARDS. Methods:A retrospective cohort study method was used, and the study subjects were hospitalized for >5 days adult patients with severe ARDS in the central intensive care unit of Henan Provincial People's Hospital from 1 March 2020 to 30 June 2023. The following patients were excluded: IC test was not completed on the 4th day of ICU admission, IC test results were unreliable, mechanical ventilation duration had exceeded 48 h at the time of ICU transfer or admission, palliative care patients and pregnant and parturient women. Using indirect calorimetry to determine VO 2 and VCO 2 values on the 4th day of admission, reviewing medical records to obtain general condition, disease information, blood gas analysis (including lactate value), diagnostic and therapeutic measures, and following up deaths by telephone and time of death. The primary outcome measure was death at 90 days, and the secondary outcome measure was death at 28 days, length of stay in ICU, total length of stay, and total hospitalization cost. Cox regression analysis and linear regression analysis were used to investigate the relationship between VO 2, VCO 2, VO 2/Lac and primary and secondary outcome indexes. Results:A total of 216 patients were enrolled, 78 patients (36.1%) died and 138 patients (63.9%) survived at 90 days. After correction for confounders, the results of multifactorial Cox regression analysis suggested that compared with the Q4 group, HR (95% CI) for 90-day risk of death in the VO 2 Q1 and Q2 groups was 3.21 (1.38, 7.49) and 3.24 (1.42, 7.38), and HR (95% CI) for 90-day risk of death in the VCO 2 Q1, Q2 and Q3 groups was 5.88 (2.33, 14.84), 4.26 (1. 60, 11.34) and 3.54 (1.34, 9.35), respectively, and the HR (95% CI) for 90-day risk of death in the VO 2/Lac Q1, Q2 and Q3 groups were 8.72 (3.01, 25.25), 8.43 (2.91, 24.47) and 4.04 (1.34, 12.17) respectively. P-trends were all <0.05, indicating that VO 2, VCO 2 and VO 2/Lac were linearly and negatively associated with the risk of 90-day mortality. In addition, VO 2, VCO 2, and VO 2/Lac were negatively associated with 28-day risk of death and higher VO 2/Lac was negatively associated with length of ICU stay. Conclusions:VO 2, VCO 2 and VO 2/Lac were negatively associated with 90-day mortality risk and 28-day mortality risk in patients with severe ARDS and may be independent risk factors predicting mortality risk of such patients.
