The prognostic impact of ventricular arterial coupling in patients with traumatic hemorrhagic shock:a single center cohort study
10.3969/j.issn.1005-6483.20240326
- VernacularTitle:心室-动脉耦联指数对创伤失血性休克病人的预后影响:一项单中心队列研究
- Author:
Xun NI
1
;
Shanshan LU
;
Chi ZHANG
;
Tingting DING
;
Aihua LIN
Author Information
1. 223800 江苏宿迁,徐州医科大学附属宿迁医院/南京鼓楼医院集团宿迁医院重症医学科
- Publication Type:Journal Article
- Keywords:
traumatic hemorrhagic shock;
left ventricular arterial coupling;
continuous cardiac output monitoring
- From:
Journal of Clinical Surgery
2024;32(12):1326-1329
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the impact of ventricular arterial coupling on the prognosis of patients with traumatic hemorrhagic shock(HTS).Methods 60 HTS patients who were hospitalized in the emergency and critical care departments of Nanjing Drum Tower Hospital Group Suqian Hospital from January 2020 to December 2022 were included.They were divided into survival group(n=30)and death group(n=30)based on their prognosis.The acute physiological and chronic health score Ⅱ(APACHEⅡ),sequential organ failure(SOFA)score,lactate(Lac),and central venous oxygen saturation(ScvO2)of the two groups of patients were monitored,respectively,Compare the central venous pressure(CVP),cardiac index(CI),stroke volume index(SVI),global end diastolic volume index(GEDVI),systemic vascular resistance index(SVRI),and mean arterial pressure(MAP)of two groups of patients under continuous monitoring of pulse indicator cardiac output(PiCCO),and calculate the left ventricular arterial coupling(VAC)index.Results The Lac levels in the survival group and death group were(2.31±1.29)mmol/L and(3.98±1.01)mmol/L,respectively,with statistical significance(P＜0.05);The ScvO2 values for the survival group and death group were(62.69±5.73)％and(60.3±5.35)％,respectively,with no significant statistical difference(P＞0.05);The survival group showed a statistically significant decrease in APACHE Ⅱ score[(18.57±2.23)points vs(23.00±3.15)points]and SOFA score[(9.40±2.15)points vs(14.07±2.26)points]compared to the death group(P＜0.05),with an increase in CI[(2.97±0.20)L/(min·m2)vs(2.73±0.27)L/(min·m2)],an increase in SVI[(50.11±4.31)ml/m2 vs(46.53±3.49)ml/m2],and a decrease in VAC[(1.34±0.19)vs(1.69±0.28)],and a statistically significant difference(P＜0.05),However,there was no significant statistical difference in CVP[(9.19±1.20)mmHg vs(9.35±1.53)mmHg)],GEDVI[(715.73±101.72)ml/m2 vs(717.93±89.07)ml/m2],SVRI[(2 061.55±701.23)dyn·sec·cm-5·m-2 vs(2 164.31±732.16)dyn·sec·cm-5·m-2],and MAP[(92.21±10.81)mmHg vs(89.19±17.33)mmHg]between the survival and death groups(P＞0.05);Logistic regression analysis showed that VAC(OR=1.41),Lac(OR=1.36),APACHE Ⅱ score(OR=1.25),SOFA score(OR=1.21),CI(OR=1.31),and SVI(OR=1.20)were risk factors for mortality in patients with traumatic hemorrhagic shock(P＜0.05).Conclusion VAC has a certain impact on the prognosis of patients with traumatic hemorrhagic shock.
