Clinical value of the differential diagnosis of severe sepsis and acute heart failure by hemodynamic monitoring
10.7619/jcmp.201723003
- VernacularTitle:血流动力学监测鉴别严重脓毒血症及急性心衰患者的临床价值
- Author:
Xuedong QIN
1
;
Quanli WANG
;
Pengfei LIU
Author Information
1. 河北省三河市市医院重症监护室
- Keywords:
hemodynamics;
severe sepsis;
acute heart failure;
receiver operating characteristics curve
- From:
Journal of Clinical Medicine in Practice
2017;21(23):8-10,14
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study and analyze value of the hemodynamic monitoring in the differential diagnosis of severe sepsis and acute heart failure.Methods A total of 86 patients with severe sepsis and acute heart failure treated with hemodynamic monitoring of PICCO were selected as the research subjects,among whom 55 patients were severe sepsis,and 31 patients were acute heart failure.The cardiac index (CI),the right atrial pressure (RAP),the pulmonary artery wedge pressure (PAWP),the mean arterial pressure (MAP),the heart rate (HR) of the patients were detected and compared.Results The RAP,PAWP levels of the patients with acute heart failure were significantly higher than that of the patients with severe sepsis.The CI level was significantly lower than that of the patients with severe sepsis,and the differences between the two groups were statistically significant (P ＜ 0.05).The area of the receiver operating characteristics curve (AUC) of CI in the differential diagnosis of severe sepsis and acute heart failure was the highest,which was 0.893.At the optimal screening limit value (Cut off value),the sensitivity and the specificity were 0.764 and 1.000.The AUC of RAP or PAWP in the differential diagnosis of severe sepsis and acute heart failure were lower than that of CI,the sensitivities at Cut off value were relatively lower,which were 0.323 and 0.484,respectively.Conclusion The invasive hemodynamic monitoring indicators of the patients with severe sepsis and acute heart failure have certain differences.Monitoring indicators can provide the basis for the early differential diagnosis and the development of treatment strategy,which is beneficial to improve the therapeutic effects and the prognosis of the patients.
