静脉至动脉二氧化碳差异在心脏性休克中可能发挥作用:一项探索性研究
Teresa López-Sobrino1, Axel Gázquez Toscano2, María Soler Selva2
1Unidad de Cuidados Intensivos Cardiológicos, Departamento de Cardiología, Hospital Clinic, Barcelona, España. Institut D´Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, España. Universitat de Barcelona, Barcelona, España.
概括
静脉至动脉CO2部分压力差 (CO2) 可能有助于管理心脏性休克. 在12-24小时之间的低二氧化碳水平可以表明心血管疾病或耐火性休克死亡风险较低.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 血液动力学 血液动力学
背景情况:
- 静脉到动脉的CO2部分压力差 (CO2) 评估了组织输液的充分性.
- 有限的数据存在于二氧化碳在心脏性休克 (CS) 中的实用性.
研究的目的:
- 在入院后48小时内描述CS患者的CO2变化.
- 评估二氧化碳与心血管疾病 (CVD) 死亡率和耐火性CS的关联.
主要方法:
- 在重症监护病房中对50名CS患者进行前性观察性研究.
- 在入院和6,12,24和48小时内进行的二氧化碳测量.
- 使用后勤回归和ROC曲线分析.
主要成果:
- 住院心血管疾病死亡率为20%.
- 二氧化碳最初达到峰值,然后在48小时内下降.
- 二氧化碳>6 mmHg在24小时与耐火性CS相关; 87%的NPV为二氧化碳<6 mmHg在12小时对心血管疾病死亡率.
结论:
- 在管理CS时,CO2可能是一个有价值的额外标记.
- 在12-24小时之间的CO2<6mmHg可以识别心血管疾病死亡率或耐火性CS的低风险患者.
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