The Journal of Practical Medicine ›› 2021, Vol. 37 ›› Issue (2): 210-214.doi: 10.3969/j.issn.1006⁃5725.2021.02.016

• Clinical Research • Previous Articles     Next Articles

Prognosis prediction of patients with septic shock by using the combination of Pcv ⁃aCO2,ScvO2 and LCR

FENG Kaijun,SONG Qiuming,WU Daorong,XUE Ming
  

  1. The Third People′s Hospital of Hefei Department of Criti⁃cal Care Medicine,Hefei 230041,China
  • Online:2021-01-25 Published:2021-01-25
  • Contact: SONG Qiuming E⁃mail:281290490@qq.com
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Abstract:

Objective The aim of this study was to explore the predictive value of the combination of central venous blood and arterial carbon dioxide partial pressure difference(Pcv ⁃aCO2),central venous oxygen saturation(ScvO2)and lactate clearance rate(LCR)on prognosis of patients with septic shock. Methods The clinical data of 70 patients with septic shock from March 2015 to may 2020 were retrospectively collected and ana⁃ lyzed. Pcv⁃aCO2 and ScvO2 were detected at 6 h and 24 h after admission,and LCR at 6 h and 24 h after admission were calculated. All patients received routine treatment and the prognosis were analyzed. Pcv ⁃ aCO2,ScvO2 and LCR were compared between patients with good and poor prognosis. The change rates of Pcv⁃aCO2,ScvO2 and LCR in patients were compared. Receiver operating characteristic curve(ROC)was applied to analyze the predictive efficacy of the combination of the three methods for poor prognosis in patients with septic shock. Results The inci⁃ dence of poor prognosis was 27.14%. Pcv ⁃aCO2 of patients with poor prognosis were higher than those with good prognosis at 6 h and 24 h after admission,and ScvO2 at 6 h and 24 h after admission were lower than those with good prognosis. Meanwhile,LCR at 6 h and 24 h after admission were lower than those in patients with good prog⁃ nosis. The Pcv⁃aCO2 of patients with good prognosis 48 hours after admission was lower than that at 6 h after admis⁃ sion,and ScvO2 was higher than that at 24 h after admission,and the LCR at 24 h after admission was higher than that at 6 h after admission in patients with good prognosis. The change rates of Pcv⁃aCO2,ScvO2 and LCR in patients with poor prognosis were lower than good prognosis. The differences were statistically significant(P < 0.05). The cut off values of Pcv⁃aCO2,ScvO2 and LCR were 10.32%,4.69% and 32.25% respectively. The sensitivity of combined prediction of poor prognosis of septic shock was similar to that of single prediction. The specificity and AUC of combined prediction were higher than those of single prediction. Conclusion The risk of poor prognosis in patients with septic shock is high. The combination of the change rates of Pcv⁃aCO2,ScvO2 efficiency in predicting poor prognosis.

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