Xu He-Ping, Zhuo Xiao-An, Yao Jin-Jian, Wu Duo-Yi, Wang Xiang, He Ping, Ouyang Yan-Hong
Department of Emergency Medicine, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China.
World J Clin Cases. 2021 May 6;9(13):3008-3013. doi: 10.12998/wjcc.v9.i13.3008.
Sepsis usually causes hemodynamic abnormalities. Hemodynamic index is one of the factors to identify the severity of sepsis and an important parameter to guide the procedure of fluid resuscitation. The present study investigated whether the assessment of hemodynamic indices can predict the outcomes of septic patients undergoing resuscitation therapy.
To evaluate the prognostic value of hemodynamic indices in patients with sepsis after fluid resuscitation.
A retrospective study was conducted in 120 patients with sepsis at Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University between October 2016 and October 2019. All patients were treated with sodium chloride combined with dextran glucose injection for fluid resuscitation. Patients' hemodynamic parameters were monitored, including heart rate (HR), cardiac index (CI), systemic vascular resistance index (SVRI), mean arterial pressure (MAP), central venous pressure (CVP), and central venous oxygen saturation. The prognostic value of hemodynamic indices was determined based on the prognosis status.
During fluid resuscitation, 86 patients developed septic shock and 34 did not. Ninety-nine patients survived and 21 patients died at 28 d after the treatment. Heart rate, CI, mean arterial pressure, SVRI, and CVP were higher in patients with septic shock and patients who died from septic shock than in non-shock patients and patients who survived, and central venous oxygen saturation was lower in patients with shock and patients who died than in non-shock patients and the survivors ( < 0.05). When prognosis was considered as a dependent variable and hemodynamic parameters was considered as independent variables, the results of a logistic regression analysis showed that CI, SVRI, and CVP were independent risk factors for septic shock, and CI was an independent risk factor for 28-d mortality ( < 0.05).
Hemodynamic indices can be used to evaluate the prognosis of septic patients after fluid resuscitation.
脓毒症通常会导致血流动力学异常。血流动力学指标是识别脓毒症严重程度的因素之一，也是指导液体复苏过程的重要参数。本研究调查了血流动力学指标评估是否能够预测接受复苏治疗的脓毒症患者的预后。
评估液体复苏后脓毒症患者血流动力学指标的预后价值。
对2016年10月至2019年10月期间在海南医学院第一附属医院/海南省人民医院收治的120例脓毒症患者进行回顾性研究。所有患者均接受氯化钠联合右旋糖酐葡萄糖注射液进行液体复苏治疗。监测患者的血流动力学参数，包括心率（HR）、心脏指数（CI）、全身血管阻力指数（SVRI）、平均动脉压（MAP）、中心静脉压（CVP）和中心静脉血氧饱和度。根据预后情况确定血流动力学指标的预后价值。
在液体复苏期间，86例患者发生脓毒症休克，34例未发生。治疗后28天，99例患者存活，21例患者死亡。发生脓毒症休克的患者以及死于脓毒症休克的患者的心率、心脏指数、平均动脉压、全身血管阻力指数和中心静脉压高于未发生休克的患者和存活患者，而发生休克的患者和死亡患者的中心静脉血氧饱和度低于未发生休克的患者和存活患者（P<0.05）。以预后为因变量、血流动力学参数为自变量进行逻辑回归分析，结果显示心脏指数、全身血管阻力指数和中心静脉压是脓毒症休克的独立危险因素，心脏指数是28天死亡率的独立危险因素（P<0.05）。
血流动力学指标可用于评估液体复苏后脓毒症患者的预后。
