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Is Carboxyhaemoglobin an Effective Bedside Prognostic Tool for Sepsis and Septic Shock Patients? Cover

Is Carboxyhaemoglobin an Effective Bedside Prognostic Tool for Sepsis and Septic Shock Patients?

Open Access
|Nov 2023

Figures & Tables

Fig. 1.

Visual description of the study (N – number of patients; SOFA - Sequential Organ Failure Assessment; APACHE II - Acute Physiology and Chronic Health Evaluation II; SAPS II - Simplified Acute Physiology Score II)
Visual description of the study (N – number of patients; SOFA - Sequential Organ Failure Assessment; APACHE II - Acute Physiology and Chronic Health Evaluation II; SAPS II - Simplified Acute Physiology Score II)

Figure 2.

Distribution by age
Distribution by age

Figure 3.

Distribution by mortality
Distribution by mortality

Fig. 4.

Positive correlation between SOFA vs. APACHE II and SOFA vs. SAPS II. No correlation between SOFA vs. NLR and SOFA vs. COHb levels on D1 (SOFA – Sequential Organ Failure Assessment; APACHE II – Acute Physiology and Chronic Health Evaluation II; SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D1 – day 1)
Positive correlation between SOFA vs. APACHE II and SOFA vs. SAPS II. No correlation between SOFA vs. NLR and SOFA vs. COHb levels on D1 (SOFA – Sequential Organ Failure Assessment; APACHE II – Acute Physiology and Chronic Health Evaluation II; SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D1 – day 1)

Fig. 5.

Positive correlation between APACHE II vs. SAPS II. No correlation between APACHE II vs. NLR, APACHE II vs. COHb levels on D1 (APACHE II – Acute Physiology and Chronic Health Evaluation II; SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D1 – day 1)
Positive correlation between APACHE II vs. SAPS II. No correlation between APACHE II vs. NLR, APACHE II vs. COHb levels on D1 (APACHE II – Acute Physiology and Chronic Health Evaluation II; SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D1 – day 1)

Fig. 6.

No correlation between SAPS II vs. NLR, SAPS II vs. COHb levels on D1 (SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D1 – day 1)
No correlation between SAPS II vs. NLR, SAPS II vs. COHb levels on D1 (SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D1 – day 1)

Fig. 7.

Negative correlation between NLR vs. COHb on D1 (NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D1 – day 1)
Negative correlation between NLR vs. COHb on D1 (NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D1 – day 1)

Fig. 8.

Positive correlation between SOFA vs. APACHE II, SOFA vs. SAPS II. No correlation between SOFA vs. NLR and SOFA vs. COHb levels on D5 (SOFA – Sequential Organ Failure Assessment; APACHE II – Acute Physiology and Chronic Health Evaluation II; SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D5 – day 5)
Positive correlation between SOFA vs. APACHE II, SOFA vs. SAPS II. No correlation between SOFA vs. NLR and SOFA vs. COHb levels on D5 (SOFA – Sequential Organ Failure Assessment; APACHE II – Acute Physiology and Chronic Health Evaluation II; SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D5 – day 5)

Fig. 9.

Positive correlation between APACHE II vs. SAPS II. No correlation between APACHE II vs. NLR, APACHE II vs. COHb levels on D5 (APACHE II – Acute Physiology and Chronic Health Evaluation II; SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D5 – day 5)
Positive correlation between APACHE II vs. SAPS II. No correlation between APACHE II vs. NLR, APACHE II vs. COHb levels on D5 (APACHE II – Acute Physiology and Chronic Health Evaluation II; SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D5 – day 5)

Fig. 10.

No correlation between SAPS II vs. NLR, SAPS II vs. COHb levels on D5 (SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D5 – day 5)
No correlation between SAPS II vs. NLR, SAPS II vs. COHb levels on D5 (SAPS II – Simplified Acute Physiology Score II; NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D5 – day 5)

Fig. 11.

No correlation between NLR vs. COHb on D5 (NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D5 – day 5)
No correlation between NLR vs. COHb on D5 (NLR – Neutrophil-Lymphocytes Ratio; COHb – Carboxyhaemoglobin; D5 – day 5)

Fig. 12.

Evolution of NLR on D1 and D5 in sepsis survivors and non-survivors (NLR – Neutrophil-Lymphocytes Ratio; D1 – day 1; D5 – day 5)
Evolution of NLR on D1 and D5 in sepsis survivors and non-survivors (NLR – Neutrophil-Lymphocytes Ratio; D1 – day 1; D5 – day 5)

Fig. 13.

Evolution of NLR on D1 and D5 in septic shock survivors and non-survivors (NLR – Neutrophil-Lymphocytes Ratio; SS – septic shock; D1 – day 1; D5 – day 5)
Evolution of NLR on D1 and D5 in septic shock survivors and non-survivors (NLR – Neutrophil-Lymphocytes Ratio; SS – septic shock; D1 – day 1; D5 – day 5)

Fig. 14.

Evolution of COHb (%) on D1 and D5 in sepsis survivors and non-survivors (COHb – Carboxyhaemoglobin; D1 – day 1; D5 – day 5)
Evolution of COHb (%) on D1 and D5 in sepsis survivors and non-survivors (COHb – Carboxyhaemoglobin; D1 – day 1; D5 – day 5)

Fig. 15.

Evolution of COHb (%) on D1 and D5 in septic shock survivors and non-survivors (COHb – Carboxyhaemoglobin; SS – septic shock; D1 – day 1; D5 – day 5)
Evolution of COHb (%) on D1 and D5 in septic shock survivors and non-survivors (COHb – Carboxyhaemoglobin; SS – septic shock; D1 – day 1; D5 – day 5)

Descriptive statistics on D1

SOFAAPACHE II (points)SAPS II (points)NLRCOHb
Minimum1.0007.00017.000.74200.000
25% Percentile6.00014.0034.508.2360.4250
Median9.00022.0056.0014.141.100
75% Percentile13.0030.0072.0025.011.500
Maximum19.0044.00118.059.672.500
Range18.0037.00101.058.932.500
Mean9.45922.3054.6117.061.080
Std.Deviation4.7009.42621.8411.760.6356
Std. Error of Mean0.60171.2072.7961.5050.08206

Site of infection and aetiology of infection of patients included in the study_

Site of infectionNumber of patientsAetiologyNumber of patients
Pulmonary36Pneumonia / Bronchopneumonia33
Abdominal27Peritonitis12
Cutaneous5Intestinal obstruction5
Urinary tract4Enterocolitis2
Bloodstream3Sepsis / septic shock of unknown origin2
Soft tissue3Pancreatitis3
Biliary tract1Urinary tract infection2
Unspecified1Cutaneous abscess5
Prosthetic joint infection1

Descriptive statistics on D5

SOFAAPACHE II (points)SAPS II (points)NLRCOHb
Minimum0.0005.00015.000.78600.000
25% Percentile2.00011.0029.005.4220.600
Median7.00018.0046.009.0051.000
75% Percentile12.0027.0061.0017.871.500
Maximum19.0034.0085.0046.7517.00
Range19.0029.0070.0045.9617.00
Mean7.35918.7445.3613.031.471
Std. Deviation5.3349.31820.4010.842.550
Std. Error of Mean0.85411.4923.2671.7140.3982

Pathogens associated with infection of patients involved in the study_

Pathogens Number of patients
Pseudomonas aeruginosa 9

Klebsiella pneumoniaeCPE8
BLSE2
unspecified2

Acinetobacter baumanii 13

Proteus vulgaris 2

Enterococcus faecalis 5

Escherichia coliBLSE4
unspecified3

Staphylococcus arureusMRSA1
MSSA2

Streptococcus pneumoniae 1

Candida spp. 8

Clostridiumdifficile 3

Other 16

MDRYes13
No48

Predictability of mortality by NLR and COHb variation from D1 to D5 of survivors and non-survivors

Survivors (n = 15)Non-survivors (n = 46)
NLRD1 ↓ D5 and COHb D1 ↓ D5119
NLRD1 ↓ D5 and COHb D1 ↑ D5114
NLRD1 ↑ D5 and COHb D1 ↑ D523
NLRD1 ↑ D5 and COHb D1 ↓ D504
NLR only on D1 and COHb only on D1116
DOI: https://doi.org/10.2478/jccm-2023-0031 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 239 - 251
Submitted on: Sep 22, 2023
Accepted on: Oct 22, 2023
Published on: Nov 14, 2023
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 times per year

© 2023 Bianca-Liana Grigorescu, Oana Coman, Anca Meda Văsieșiu, Anca Bacârea, Marius Petrișor, Irina Săplăcan, Raluca Ștefania Fodor, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.