Mean 24-hour end-tidal carbon dioxide following diagnosis predicts mortality in patients with sepsis

doi:10.5847/wjem.j.1920-8642.2025.067

World Journal of Emergency Medicine ›› 2025, Vol. 16 ›› Issue (4): 383-386.doi: 10.5847/wjem.j.1920-8642.2025.067

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Mean 24-hour end-tidal carbon dioxide following diagnosis predicts mortality in patients with sepsis

Jingyi Wang¹, Li Weng¹, Jun Xu²(), Bin Du¹()

¹Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
²Emergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China

Received:2024-11-06 Accepted:2025-04-02 Online:2025-07-18 Published:2025-07-01
Contact: Jun Xu,Bin Du E-mail:xujunfree@126.com;dubin98@gmail.com

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Abstract

Jingyi Wang, Li Weng, Jun Xu, Bin Du. Mean 24-hour end-tidal carbon dioxide following diagnosis predicts mortality in patients with sepsis[J]. World Journal of Emergency Medicine, 2025, 16(4): 383-386.

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Table 1.

Table 2.

Figure 1.

References 13

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Variables	Survival (n=1,279)	Non-survival (n=453)	P-value
Demographics
Age, years, mean±SD	62 ± 16	68 ± 15	<0.001
Male gender, n (%)	759 (59.3)	246 (54.3)	0.062
Comorbidities, n (%)
Cardiac disease	437 (34.2)	171 (37.7)	0.170
Chronic pulmonary disease	326 (25.5)	118 (26.0)	0.815
Liver disease	185 (14.5)	85 (18.8)	0.030
Cerebrovascular disease	166 (13.0)	90 (19.9)	<0.001
CKD	255 (19.9)	100 (22.1)	0.333
Severity of illness, mean±SD
SOFA score	4 ± 2	5 ± 3	<0.001
SAPS II	43 ± 14	55 ±15	<0.001
EtCO₂ measurement
mEtCO₂, mmHg, mean±SD	36 ± 6	31 ± 7	<0.001
iEtCO₂, mmHg, mean±SD	35 ± 7	32 ± 7	0.001
Measurement frequency, median (IQR)	4 (2-5)	4 (3-5)	0.863
Vital signs
MAP, mmHg, median (IQR)	60 (53-69)	57 (49-68)	0.002
HR, beats per minute, mean±SD	103 ± 31	110 ± 32	<0.001
Temperature, °C, mean±SD	36.6 ± 1.3	36.1 ± 1.5	<0.001
RR, breaths per minute, mean±SD	24 ± 12	25 ± 12	0.041
Laboratory results, mean±SD
HCO₃^-, mmol/L	20.1 ± 6.0	17.2 ± 6.1	<0.001
Lactate, mmol/L	2.3 ± 1.6	4.0 ± 3.4	<0.001
Treatments, n (%)
Vasopressor	522 (40.8)	215 (47.5)	0.014
CRRT	35 (2.7)	43 (9.5)	<0.001
IMV	1,250 (97.7)	445 (98.2)	0.526

Outcomes	Low mEtCO₂ (n=173)	High mEtCO₂ (n=577)	P-value
28-day mortality, n (%)	82 (47.4)	118 (20.5)	<0.001
Ventilator-free days, d, median (IQR)	3 (0-23)	22 (8-26)	<0.001
Vasopressor-free days, d, median (IQR)	21 (0-28)	28 (20-28)	<0.001
ICU LOS, d, median (IQR)	5 (3-10)	5 (3-11)	0.088

Mean 24-hour end-tidal carbon dioxide following diagnosis predicts mortality in patients with sepsis

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