Evaluation of Effect of Pv-aCO2-Gap on Outcomes Using Standard Resuscitation in Adult Polytrauma ICU Patients - Randomized Control Trial

What this Trial Is About

Researchers are studying adult patients who have suffered multiple traumatic injuries and are admitted to the Intensive Care Unit (ICU) from various hospital locations. The study compares two approaches to guiding treatment: one uses the difference between carbon dioxide levels in venous and arterial blood (Pv-aCO2 gap), and the other uses standard resuscitation parameters typically applied in critical care. This randomized controlled trial aims to evaluate whether monitoring the Pv-aCO2 gap can improve patient outcomes compared to standard care. Participants will be randomly assigned to one of two groups. The intervention group will have treatment guided by measurements of the Pv-aCO2 gap using arterial and central venous blood samples taken shortly after ICU admission and at several time points up to 72 hours. The control group will receive treatment based on standard resuscitation parameters including arterial base deficit, pH, lactate, and bicarbonate levels. Both groups will have a central venous catheter and an arterial line inserted for routine blood sampling and monitoring. Throughout the study, blood samples will be collected within 1 hour of ICU admission and then at 6, 12, 24, 48, and 72 hours for blood gas analysis. The primary outcome measured is the length of mechanical ventilation, with additional assessments including ICU stay duration, ICU mortality, and qSOFA scores at admission and follow-up time points. All measurements will be obtained using a bedside blood gas analyzer, and patient care will be closely monitored during their ICU stay to compare the effectiveness of the two resuscitation methods.

Pv-aCO₂ Gap-Guided Resuscitation in Adult Polytrauma Patients: A Prospective Randomized Controlled Trial