(1471) The Glucose Difference Between Artery and Interstitial Fluid Predicts Mortality in Septic Shock

Introduction: Impaired microcirculation in septic shock is closely related to organ dysfunction and mortality. We hypothesized that the difference in glucose between arterial blood and interstitial fluid (GA-I) could be used as a marker to assess the severity of microcirculatory disorders in patients with septic shock.

Methods: This was a prospective observational study that included patients with septic shock admitted to a tertiary teaching hospital. For each patient, signs reflecting organ tissue perfusion, such as lactate, skin mottling score, capillary refill time, arterial-venous carbon dioxide pressure difference (Pc-aCO2), arterial- transcutaneous carbon dioxide pressure difference (Ptc-aCO2), urine output, and GA-I, were recorded at the time of inclusion (H0), H2, H4, H6, and H8. The correlations between these parameters were compared, and the distribution of ICU mortality in GA-I was analyzed. The area under the receiver operating characteristic curve (AUROC) was used to evaluate the accuracy of GA-I in predicting ICU mortality in septic shock.

Results: A total of 25 patients were included, 12 patients (48%) died during ICU stay. GA-I was correlated with lactate (R -0.18, P < 0.05) and capillary refill time (R-0.38, P < 0.01). The ICU mortality rate in patients with septic shock whose GA-I was less than 0.5mmol/L or greater than 2.5mmol/L (75%) was significantly higher than that of patients whose GA-I was in the range of 0.5-2.5mmol/L (23.1%). Combined with lactate, capillary refill time and GA-I, the AUROC for predicting ICU mortality was high at 0.936.

Conclusions: GA-I can reflect the microcirculatory status in patients with infectious shock, and its combination with CRT and lactate can better predict ICU mortality risk in septic shock.