Associazione Nazionale Medici Cardiologi Ospedalieri

congress.anmco.it

CONGRESS ABSTRACT

CONGRESS ABSTRACT

PROGNOSTIC VALUE OF VENOUS-TO-ARTERIAL CARBON DIOXIDE DIFFERENCE IN ISCHEMIC CARDIOGENIC SHOCK: A SINGLE-CENTER RETROSPECTIVE STUDY

Carabotta Chiara Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Zaccaro Stefania Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Coraducci Francesca Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Belfioretti Leonardo Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Nazziconi Marco Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Battistoni Ilaria Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Francioni Matteo Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Matassini Maria Vittoria Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Angelini Luca Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Pongetti Giulia Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Shkoza Matilda Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche | Marini Marco Ancona (An) – Azienda Ospedaliero Universitaria Delle Marche

Background Cardiogenic shock (CS) is a complex clinical condition associated with high mortality, characterized by severe impairment of cardiac output and systemic hypoperfusion. The venous-to-arterial carbon dioxide partial pressure difference (ΔPCO₂) has been proposed as an alternative marker of tissue hypoperfusion and microcirculatory dysfunction; however, its prognostic value in ischemic cardiogenic shock remains unclear. Aims To evaluate the prognostic role of ΔPCO₂ during the first 24 hours of hospitalization in patients with ischemic cardiogenic shock. Methods This single-center, retrospective, observational study included 76 patients admitted to the cardiac intensive care unit for ischemic cardiogenic shock. ΔPCO₂ was recorded at admission and at 3, 6, 12, and 24 hours when available. Patients were retrospectively classified into survivors (n=46) and non-survivors (n=30) according to in-hospital mortality. Clinical, hemodynamic, laboratory, and blood gas data were collected. ΔPCO₂ values were compared between the two groups. Results In-hospital mortality was significantly associated with older age, diabetes mellitus, impaired renal function, higher central venous pressure, reduced left ventricular ejection fraction, and more advanced SCAI shock stage. Lactate levels at 12 and 24 hours were significantly higher in non-survivors. Conversely, although ΔPCO₂ values were pathologically elevated at admission in most patients, no significant differences were observed between survivors and non-survivors at any time point, nor was ΔPCO₂ independently associated with in-hospital mortality. Conclusions In patients with ischemic cardiogenic shock, ΔPCO₂ did not demonstrate an independent prognostic value for in-hospital mortality, despite confirming its role as a marker of hypoperfusion. Lactate kinetics, SCAI classification, and organ function parameters remain the most reliable prognostic indicators. Further prospective studies on larger cohorts are warranted to better define the clinical role of ΔPCO₂ in this setting. Keywords: cardiogenic shock; myocardial infarction; mortality; prognosis; venous-to-arterial pCO₂ difference.