Sazgar Mohammad, Golikhatir Iraj, Pashaee Seyedeh Masoomeh, Tirandaz Fatemeh, Firouzian Abolfazl, Miniahidashti Hamed
Department of Emergency Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Anesthesiology, Division of Intensive Care Unit, Mazandaran University of Medical Sciences, Sari, Iran.
Caspian J Intern Med. 2021 Fall;12(4):580-585. doi: 10.22088/cjim.12.4.580.
Septic shock is a critical medical condition and immediate intervention is required as well as hemodynamic stability using fluid and vasopressor. Direct relationship between changes in ETco2 and changes in the cardiac output. We evaluated the study by comparing the effect of using norepinephrine or dopamine on ETco2 of patients with septic shock.
A clinical trial study was performed on 138 patients with primary diagnosis of septic shock. 70 patients received norepinephrine and 68 patients received dopamine. Patients' end tidal carbon dioxide (ETco2), mean arterial pressure (MAP), pulse rate (PR), arterial blood gas (ABG) levels in two groups were measured and compared at baseline and after 30 and 120 minutes after inotrope infusion. Variables were compared by means of an unpaired student t-test, an unadjusted chi-square test.
138 patients, 70 treated with norepinephrine infusion and 68 with dopamine infusion were included in the study. ETco2 level significantly increased within 120 minutes of treatment in the norepinephrine group (31.10±9.65) compared to the dopamine group (23.71±9.66) (P=0.001). MAP significantly decreased in the group of norepinephrine 30 minutes after treatment (71.71±20.460) (P=0.014) and pulse rate also significantly decreased in the norepinephrine group compared to the dopamine group in 30 minutes (98.07±10.63 vs 106.43±13.54) and 120 minutes (91.15±6.18 vs 103.51±2057) after treatment (P=0.001).
Tissue perfusion and fluid responsiveness of the shock in the norepinephrine group showed improvement. Using ETco2 as a measure for determining volume assessment in patients undergoing mechanical ventilation by septic shock is applicable.
感染性休克是一种危急的医疗状况，需要立即进行干预，并使用液体和血管升压药维持血流动力学稳定。呼气末二氧化碳（ETco2）变化与心输出量变化之间存在直接关系。我们通过比较去甲肾上腺素或多巴胺对感染性休克患者ETco2的影响来评估该研究。
对138例初步诊断为感染性休克的患者进行了一项临床试验研究。70例患者接受去甲肾上腺素治疗，68例患者接受多巴胺治疗。在基线以及输注血管活性药物后30分钟和120分钟时，测量并比较两组患者的呼气末二氧化碳（ETco2）、平均动脉压（MAP）、脉搏率（PR）、动脉血气（ABG）水平。变量通过不成对学生t检验、未校正卡方检验进行比较。
138例患者纳入研究，其中70例接受去甲肾上腺素输注治疗，68例接受多巴胺输注治疗。与多巴胺组（23.71±9.66）相比，去甲肾上腺素组在治疗120分钟内ETco2水平显著升高（31.10±9.65）（P = 0.001）。去甲肾上腺素组在治疗30分钟后平均动脉压显著降低（71.71±20.460）（P = 0.014），且在治疗30分钟（98.07±10.63对106.43±13.54）和120分钟（91.15±6.18对103.51±20.57）后，去甲肾上腺素组的脉搏率也比多巴胺组显著降低（P = 0.001）。
去甲肾上腺素组休克患者的组织灌注和液体反应性有所改善。将ETco2用作评估感染性休克机械通气患者容量评估的指标是可行的。
