Markakis Konstantinos, Georgianou Eleni, Pagonas Nikolaos, Bertram Sebastian, Seidel Maximilian, Babel Nina, Westhoff Timm H, Seibert Felix S
University Hospital Marien Hospital Herne, Department of Nephrology, Ruhr-University of Bochum, Herne, Germany; University Hospital AHEPA, First Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
University Hospital Brandenburg, Department of Cardiology, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany.
J Cardiothorac Vasc Anesth. 2025 Aug;39(8):2019-2030. doi: 10.1053/j.jvca.2025.04.002. Epub 2025 Apr 7.
Elevated central blood pressure (BP) and arterial stiffness are risk factors for cardiovascular mortality. However, their prognostic value in patients with hemodynamic shock has not been studied broadly. Evolved BP monitoring devices enable the noninvasive assessment of central BP and arterial stiffness. The objective of this study was to evaluate the prognostic value of central BP and arterial stiffness measurements, delivered by 2 noninvasive devices, in patients with septic or cardiogenic shock admitted to the intensive care unit.
This is a monocenter, prospective, cohort study.
This study was conducted in a tertiary university hospital.
We enrolled 57 patients who were admitted to the intensive care unit with septic or cardiogenic shock.
None.
Central BP and arterial stiffness indices like pulse wave velocity (PWV) and Aix were recorded with a Mobil-o-Graph 24h PWA and SphygmoCor XCEL. Age, catecholamine dosage, resuscitation incidence before inclusion, C-reactive protein, leukocytes, and creatinine were recorded as possible confounders. With regard to the confounders, central systolic BP measured in the first 24 hours, was predictive of 6-month mortality (odds ratio, 0.9; p < 0.05). Aix, recorded by Mobil-o-Graph 24h PWA, was associated with death in the first 14 days (odds ratio, 1.11; p = 0.03). An increased PWV was not associated with adverse outcomes.
Low central BP and increased Aix were linked to a higher mortality in shock patients. PWV had no prognostic value.
中心血压（BP）升高和动脉僵硬度是心血管死亡的危险因素。然而，它们在血流动力学休克患者中的预后价值尚未得到广泛研究。先进的血压监测设备能够对中心血压和动脉僵硬度进行无创评估。本研究的目的是评估两种无创设备所测得的中心血压和动脉僵硬度测量值在入住重症监护病房的脓毒性或心源性休克患者中的预后价值。
这是一项单中心、前瞻性队列研究。
本研究在一家三级大学医院进行。
我们纳入了57例因脓毒性或心源性休克入住重症监护病房的患者。
无。
使用Mobil-o-Graph 24小时脉搏波分析（PWA）和SphygmoCor XCEL记录中心血压和动脉僵硬度指标，如脉搏波速度（PWV）和增强指数（Aix）。记录年龄、儿茶酚胺剂量、纳入前的复苏发生率、C反应蛋白、白细胞和肌酐作为可能的混杂因素。关于混杂因素，在最初24小时测得的中心收缩压可预测6个月死亡率（比值比，0.9；p<0.05）。Mobil-o-Graph 24小时PWA记录的Aix与前14天的死亡相关（比值比，1.11；p=0.03）。PWV升高与不良结局无关。
中心血压低和Aix升高与休克患者较高的死亡率相关。PWV没有预后价值。
