与心脏输出变化相比,CO2差距的变化是对静脉输入体积膨胀和/或在败血性休克中血管压缩剂治疗的反应
F Faris1, A El-Houfi2, M El Shahat3
1Critical Care Medicine Department, Faculty of Medicine, Cairo University, Egypt.
概括
测量二氧化碳差异的PCO2差距有效地预测了败血症休克患者的心脏输出变化. 这种非侵入性标志物有助于评估复苏的充分性和指导流体管理.
科学领域:
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
- 消毒冲击管理 消毒冲击管理
背景情况:
- 静脉和动脉血液 (∆PCO2或CO2间隙) 之间的二氧化碳 (PCO2) 部分压力差异与性休克复苏期间的心脏指数相关.
- ∆PCO2的早期监测可以评估心脏输出 (CO) 对组织 perfusion 的充足性.
研究的目的:
- 调查∆PCO2变化在早期败血症冲击管理中的有用性.
- 为了比较∆PCO2的预测值与心脏输出 (CO) 监测.
主要方法:
- 一项对76名败血症休克患者的观察前性研究.
- 在初始复苏前后监测∆PCO2和CO变化.
- 分析了∆PCO2,CO,ICU停留时间和28天死亡率之间的关系.
主要成果:
- 复苏期间的∆PCO2变化预测了心脏指数≥15%的变化 (AUC 0.727).
- 二氧化碳差距比率也预测了心脏指数≥15%的变化 (AUC 0.745).
- 根据差距/差距比率观察到28天死亡率的显著差异.
结论:
- 周周复苏∆PCO2和间隙/间隙比是有价值的非侵入性床边标记.
- 这些标记可以预测CO的变化和预加载响应度.
- PCO2间隙变化与CO变化相关,可能表明性休克时的液体反应.
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