Objective:To explore the value of using the venous-arterial carbon dioxide partial pressure difference and the arterial-venous oxygen content difference ratio(ΔP_(CO2)/Ca-v_(O2))as targets to guide early tissue hypop...Objective:To explore the value of using the venous-arterial carbon dioxide partial pressure difference and the arterial-venous oxygen content difference ratio(ΔP_(CO2)/Ca-v_(O2))as targets to guide early tissue hypoperfusion in sepsis in plateau areas.Methods:90 sepsis patients admitted to the Third People’s Hospital of Xining and Golmud People’s Hospital from June 2017 to December 2022 were selected as the research subjects,and they were divided into the Scv_(O2)(central venous oxygen saturation)group and theΔP_(CO2)/Ca-v_(O2)group,with 45 cases in each group.The two groups were treated with early shock resuscitation according to different protocols.The hemodynamic characteristics of the two groups of patients before and after resuscitation were observed,and the volume responsiveness was evaluated.The ROC(receiver operating characteristic)curve was used to analyze the significance ofΔP_(CO2)/Ca-v_(O2),Scv_(O2),lactate,lactate clearance,and urine output in evaluating patient prognosis and the correlation betweenΔP_(CO2)/Ca-v_(O2)and the above indicators was explored.Results:Compared with before resuscitation,after fluid resuscitation,the heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),cardiac index(CI),lactate,lactate clearance rate,and urine output of the two groups of patients were significantly improved(P<0.05);in terms of therapeutic effect,the 28-day mortality rate,6-hour fluid balance,and lactic acid clearance of theΔP_(CO2)/Ca-v_(O2)group were better than the Scv_(O2)group.The ROC characteristic curve showed that theΔP_(CO2)/Ca-v_(O2)value can effectively predict the prognosis of patients(AUC=0.907,sensitivity was 97%,specificity was 72.4%,and critical value was 1.84).ΔP_(CO2)/Ca-v_(O2)significantly correlated with Scv_(O2),lactic acid,and lactic acid clearance rate.Conclusion:TheΔP_(CO2)/Ca-v_(O2)value can be used to guide fluid resuscitation in early hypoperfusion in sepsis in plateau areas,improve patients’hemodynamics,reduce lactate indicators,and increase urine output.ΔP_(CO2)/Ca-v_(O2)level>1.84 can effectively improve patient prognosis.展开更多
基金2017 Xining Citizens’Biotechnology Plan Project(Project number:2017-K-15)。
文摘Objective:To explore the value of using the venous-arterial carbon dioxide partial pressure difference and the arterial-venous oxygen content difference ratio(ΔP_(CO2)/Ca-v_(O2))as targets to guide early tissue hypoperfusion in sepsis in plateau areas.Methods:90 sepsis patients admitted to the Third People’s Hospital of Xining and Golmud People’s Hospital from June 2017 to December 2022 were selected as the research subjects,and they were divided into the Scv_(O2)(central venous oxygen saturation)group and theΔP_(CO2)/Ca-v_(O2)group,with 45 cases in each group.The two groups were treated with early shock resuscitation according to different protocols.The hemodynamic characteristics of the two groups of patients before and after resuscitation were observed,and the volume responsiveness was evaluated.The ROC(receiver operating characteristic)curve was used to analyze the significance ofΔP_(CO2)/Ca-v_(O2),Scv_(O2),lactate,lactate clearance,and urine output in evaluating patient prognosis and the correlation betweenΔP_(CO2)/Ca-v_(O2)and the above indicators was explored.Results:Compared with before resuscitation,after fluid resuscitation,the heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),cardiac index(CI),lactate,lactate clearance rate,and urine output of the two groups of patients were significantly improved(P<0.05);in terms of therapeutic effect,the 28-day mortality rate,6-hour fluid balance,and lactic acid clearance of theΔP_(CO2)/Ca-v_(O2)group were better than the Scv_(O2)group.The ROC characteristic curve showed that theΔP_(CO2)/Ca-v_(O2)value can effectively predict the prognosis of patients(AUC=0.907,sensitivity was 97%,specificity was 72.4%,and critical value was 1.84).ΔP_(CO2)/Ca-v_(O2)significantly correlated with Scv_(O2),lactic acid,and lactic acid clearance rate.Conclusion:TheΔP_(CO2)/Ca-v_(O2)value can be used to guide fluid resuscitation in early hypoperfusion in sepsis in plateau areas,improve patients’hemodynamics,reduce lactate indicators,and increase urine output.ΔP_(CO2)/Ca-v_(O2)level>1.84 can effectively improve patient prognosis.
