Keywords
ScvO2
Sepsis
Plateau area
Prognosis
Submitted : 2023-12-30
Accepted : 2024-01-14
Published : 2024-01-29
Abstract
Objective: To explore the value of using the venous-arterial carbon dioxide partial pressure difference and the arterial-venous oxygen content difference ratio (ΔPCO2/Ca-vO2) 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 ScvO2 (central venous oxygen saturation) group and the ΔPCO2/Ca-vO2 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 of ΔPCO2/Ca-vO2, ScvO2, lactate, lactate clearance, and urine output in evaluating patient prognosis and the correlation between ΔPCO2/Ca-vO2 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 the ΔPCO2/Ca-vO2 group were better than the ScvO2 group. The ROC characteristic curve showed that the ΔPCO2/Ca-vO2 value can effectively predict the prognosis of patients (AUC = 0.907, sensitivity was 97%, specificity was 72.4%, and critical value was 1.84). ΔPCO2/Ca-vO2 significantly correlated with ScvO2, lactic acid, and lactic acid clearance rate. Conclusion: The ΔPCO2/Ca-vO2 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. ΔPCO2/Ca-vO2 level > 1.84 can effectively improve patient prognosis.
Corrigendum available at: https://www.doi.org/10.26689/jcnr.v8i2.6467
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