Relationship between ventricular arterial coupling and haemodynamics in patients with sepsis and its predictive value for prognosis
- VernacularTitle:心室动脉偶联与脓毒症患者血流动力学的关系及对预后的预测价值
- Author:
Yongjun FAN
1
;
Wenfang LIU
;
Yachao LU
Author Information
- Publication Type:Journal Article
- Keywords: sepsis; hemodynamics; prognosis; ventricular arterial coupling
- From: Tianjin Medical Journal 2025;53(4):402-406
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the relationship between ventricular arterial coupling(VAC)and haemodynamics of patients with sepsis and the predictive value for the 28-day prognosis.Methods A total of 164 patients with sepsis were selected and given fluid resuscitation treatment(infusion of 30 mL/kg of crystalloid over 3 h),and changes of VAC[effective aortic elasticity(Ea)/ventricular end-systolic elasticity(Ees)]values and hemodynamic parameters of patients resuscitated for 0 h,24 h and 72 h were observed.The difference between Ea/Ees for 24 h and 72 h of resuscitation and 0 h was calculated.Pearson method was used to analyze the correlation between Ea/Ees and Δcentral venous pressure(CVP),Δspiratory volume index(SVI)and Δcardiac index(CI).According to the 28-day prognosis,patients were divided into two groups:the survival group(123 cases)and the death group(41 cases).General information was collected in two groups of patients.The predictive values of 24 h ΔEa/Ees and 72 h ΔEa/Ees for 28-day death in sepsis patients were analyzed by multivariate Cox regression models and receiver operating characteristics(ROC)curve.Results The Ea/Ees of 164 patients resuscitated for 24 h and 72 h were lower than those of 0 h,and the Ea/Ees of 72 h was lower than that of 24 h(all P<0.05).CVP,SVI and CI of 164 patients resuscitated for 24 h and 72 h were higher than those of 0 h,and the CVP,SVI and CI of 24 h was higher than that of 72 h(all P<0.05).The 24 h ΔEa/Ees was significantly lower than that of 72 h ΔEa/Ees(P<0.05),and 24 h ΔCVP,SVI and CI were higher than those of 72 h(P<0.05).There was a negative correlation between 24 h ΔEa/Ees and 24 h ΔCVP,24 h ΔSVI and 24 h ΔCI(P<0.05).Acute Physiology and Chronic Health Status Score II(APACHE Ⅱ)≥20 points,Sequential Organ Failure Score(SOFA)≥10 points,24 h ΔEa/Ees and 72 h ΔEa/Ees were higher in the death group than those in the survival group(P<0.05).Elevated APACHE Ⅱ,SOFA,24 h ΔEa/Ees and 72 h ΔEa/Ees were risk factors affecting the 28-day prognosis of patients with sepsis(P<0.05).The 24-hour ΔEa/Ees and 72-hour ΔEa/Ees were more effective in predicting the 28 d prognosis of patients with sepsis(P<0.05).Conclusion Changes of Ea/Ees can better reflect the haemodynamic changes in sepsis patients in the early stages of treatment and help to predict the 28-day prognosis of sepsis patients.
