Randomized controlled study of fluid resuscitation regimen centered on ΔPCO2/ΔCa-vO2 in the treatment of early tissue hypoperfusion in sepsis
ZOU Chunxi1 GU Zenghui2
1.Department of Critical Care Medicine, the 903th Hospital of the Joint Support Force of the Chinese People’s Liberation Army, Zhejiang Province, Hangzhou 310016, China;
2.Department of Orthopaedics Medicine, the 117th Hospital of the Chinese People’s Liberation Army, Jiangsu Province, Nanjing 310007, China
Abstract：Objective To investigate the effect of fluid resuscitation based on the ratio of the difference of partial pressure of carbon dioxide in venous-arterial blood and the difference of oxygen content in arterial-venous blood (ΔPCO2/ΔCa-vO2) in the treatment of early tissue hypoperfusion in sepsis. Methods A total of 120 patients with sepsis admitted to the 903th Hospital of the Joint Support Force of the People’s Liberation Army from June 2017 to June 2019 were selected as the research subjects. They were divided into ΔPCO2/ΔCa-vO2 group and oxygen saturation in central venous blood (ScvO2) group by random number table method, with 60 patients in each group. The ΔPCO2/ΔCa-vO2 group was treated with fluid resuscitation regimen centered on ΔPCO2/ΔCa-vO2, and the ScvO2 group was treated with fluid resuscitation regimen centered on ScvO2. The hemodynamic indexes and outcome indexes before and after treatment were observed in the two groups. Results After treatment, heart rate and lactate level in two groups were lower than those before treatment, mean arterial pressure, central venous pressure, and lactate clearance were higher than those before treatment, the cardiac index of ΔPCO2/ΔCa-vO2 group was higher than that before treatment, and the central venous pressure, cardiac index, and lactate clearance in ΔPCO2/ΔCa-vO2 group were higher than those in ScvO2 group, with statistical significance (P ＜ 0.05). The hospitalization time and mechanical ventilation time of ΔPCO2/ΔCa-vO2 group were shorter than those of ScvO2 group, and the fluid consumption to achieve the six hours recovery goal was lower than ScvO2 group, with statistical significance (P ＜ 0.05). There was no significant difference in 28-day mortality between the two groups (P ＞ 0.05). Conclusion The fluid resuscitation regimen with ΔPCO2/ΔCa-vO2 as the center is more effective in treating early sepsis hypoperfusion.
邹春喜1 顾增辉2. 以ΔPCO2/ΔCa-vO2为中心的液体复苏方案治疗脓毒症早期组织低灌注的随机对照研究[J]. 中国医药导报, 2021, 18(25): 89-92,102.
ZOU Chunxi1 GU Zenghui2. Randomized controlled study of fluid resuscitation regimen centered on ΔPCO2/ΔCa-vO2 in the treatment of early tissue hypoperfusion in sepsis. 中国医药导报, 2021, 18(25): 89-92,102.
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