Factors of affecting survival of patients with septic shock after fluid resuscitation and the significance of NICaS in monitoring hemodynamic indicators of microcirculation
10.3969/j.issn.1672-8270.2024.11.015
- VernacularTitle:影响脓毒症休克患者体液复苏后生存的因素及阻抗心输出量测量系统监测微循环血流动力学指标的意义
- Author:
Patiguli·Muhemaiti
1
;
Jiming LI
Author Information
1. 新疆医科大学第一附属医院急救中心重症监护室 乌鲁木齐 830000
- Keywords:
Septic shock;
Hemodynamic indicator;
Heart function;
Prognosis;
Noninvasive Cardiac Output Monitoring System(NICaS)
- From:
China Medical Equipment
2024;21(11):76-80
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore and analyze the factors of affecting survival in patients with septic shock after fluid resuscitation,and the significance of noninvasive cardiovascular output monitoring system(NICaS)in monitoring hemodynamic indicators of microcirculation.Methods:A retrospective analysis was conducted on the clinical data of 90 patients with sepsis who admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2020 to March 2022.According to whether occurred survival situation of the 28-day prognosis,these patients were divided into survival group(59 cases)and non-survival group(31 cases).General documents,hemodynamic indicators,and indicators of cardiac function were compared between the two groups,and the influence of hemodynamic indicators,score of Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ),change and prognosis of cardiac function of patients of septic shock were analyzed.Results:The APACHE Ⅱ score(19.21±1.82)of the non-survival group was significantly higher than that(15.68±2.31)of the survival group,with statistically significant difference between the two groups(t=7.947,P＜0.05).There was no significant difference in heart rate(HR)between non-survival and the survival groups(P＞0.05).Compared with the mean arterial pressure(MAP),systemic vascular resistance index(SVRI)and cardiac index(CI)of survival group,the MAP and CI of non-survival group were lower,and the SVRI of non-survival group was higher,and the differences of them between two groups were significant(t=4.887,5.398,7.057,P＜0.05),respectively.There were no significant differences in left ventricular ejection fraction(LVEF),left atrial diameter(LAD),left ventricular posterior wall thickness(LVPWd),interventricular septal thickness(IVSd),E-peak velocity(E),A-peak velocity(A),and E/A ratio between non-survival group and survival groups(P＞0.05).However,the LVEDD value of non-survival group was significantly higher than that of survival group,and the difference of that between two groups was statistically significant(t=9.887,P＜0.05).The 28-day prognoses of patients with septic shock were used as dependent variable,and the hemodynamic indicators and cardiac indicators at the 7th day after admitted to hospital were used as independent variables,and the APACHE Ⅱ score,MAP,SVRI,CI and LVEDD with significant difference in multifactor analysis were included in logistic regression analysis equation.The results showed that APACHE Ⅱ score,CI and LVEDD could be used as high-risk independent factors that affected the prognosis of patients with septic shock(OR=1.674,0.902,1.225,P＜0.05),respectively.Conclusion:APACHE Ⅱ score,CI and LVEDD can be used as high-risk independent factors that affect the prognosis of patients with septic shock.The effect will be bigger on prognosis when patients with septic shock occurred dysfunctions of cardiac contraction and relaxation at the same time.The application of NICaS monitoring system can effectively reflect the changes of hemodynamic indicators of microcirculation of the body.
