Value of P(v-a)CO2 and C(v-a)CO2 in evaluating volume responsiveness in patients with septic shock
10.11816/cn.ni.2025-241559
- VernacularTitle:P(v-a)CO2、C(v-a)CO2对脓毒性休克患者容量反应性的评估价值
- Author:
Xiaodong XIE
1
;
Xiaobo WANG
1
;
Zhouwei XU
1
Author Information
1. 安徽医科大学第一附属医院急诊ICU,安徽 合肥 230022
- Publication Type:Journal Article
- Keywords:
Septic shock;
Volume responsiveness;
Veno-arterial carbon dioxide gradient;
Veno-arterial carbon di-oxide content difference;
Influencing factor
- From:
Chinese Journal of Nosocomiology
2025;35(11):1638-1643
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the value of Partial pressure difference of carbon dioxide between venous and arterial blood[P(v-a)CO2]and content difference of carbon dioxide between venous and arterial blood[C(v-a)CO2]in evaluating volume responsiveness in patients with septic shock.METHODS The clinical data of 103 pa-tients with septic shock who were admitted to the First Affiliated Hospital of Anhui Medical University from Jan.2021 to Dec.2023 were retrospectively analyzed.According to the monitoring results of cardiac output(CO)after volume load test,the patients were divided into the volume-responsive group(n=78)and the volume-unrespons-ive group(n=25).The clinical data,P(v-a)CO2,C(v-a)CO2 and CO before volume expansion(T0),immediate-ly after volume expansion(T1),10 min after volume expansion(T2),30 min after volume expansion(T3)and 60 min after volume expansion(T4)were collected.The correlation between P(v-a)CO2,C(v-a)CO2 and CO was analyzed by Pearson correlation analysis.Logistic regression analysis was used to evaluate the influencing factors in assessing the volume responsiveness by P(v-a)CO2 and C(v-a)CO2.The value of P(v-a)CO2 and C(v-a)CO2 in as-sessing volume responsiveness was analyzed using receiver operating characteristic(ROC)curves.RESULTS At T1,T2 and T3 time-point,P(v-a)CO2 and C(v-a)CO2 in the volume-responsive group were lower than those in the volume-unresponsive group(P＜0.05),and CO in the volume-responsive group was higher than that in the volume-unresponsive group(P＜0.05).P(v-a)CO2 and C(v-a)CO2 were negatively correlated with CO(r=-0.344,P＜0.001;r=-0.362,P＜0.001).P(v-a)CO2 was positively correlated with C(v-a)CO2(r=0.380,P＜0.001).P(v-a)CO2 and C(v-a)CO2 at T1,T2 and T3 time-point were influencing factors in assessing volume responsiveness in patients with septic shock(P＜0.05).At T1,T2 and T3 time-point,the sensitivity of P(v-a)CO2 for assessing volume responsiveness was 76.00％,80.00％,and 84.00％,respectively.The specificity was 65.38％,74.36％,and 75.64％,respectively.The sensitivity of C(v-a)CO2 for assessing volume responsive-ness was 72.00％,96.00％and 76.00％,respectively,with the specificity of 73.08％,73.08％and 67.95％,respectively.CONCLUSION P(v-a)CO2 and C(v-a)CO2 immediately after volume expansion,and at 10 min and 30 min after volume expansion provide good reference for evaluating volume responsiveness in patients with septic shock.
