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. 2022 Oct 7:2022:1192902.
doi: 10.1155/2022/1192902. eCollection 2022.

Relationship between Dynamic Changes of Microcirculation Flow, Tissue Perfusion Parameters, and Lactate Level and Mortality of Septic Shock in ICU

Xuebing Yang  1 , Yaqing Zhou  1 , Aiming Liu  1 , Zunguo Pu  1
Affiliations

Relationship between Dynamic Changes of Microcirculation Flow, Tissue Perfusion Parameters, and Lactate Level and Mortality of Septic Shock in ICU

Xuebing Yang et al. Contrast Media Mol Imaging. .

Abstract

Background: Septic shock is a common clinical critical disease with high mortality, hemodynamic instability, and easy to be complicated with multiple organ failure. The rapid progress of the patient's condition poses a serious threat to patient's safety.

Aim: To investigate the relationship between the dynamic monitoring of microcirculation perfusion parameters and blood lactic acid level and the prognosis of patients with infection shock in ICU.

Methods: A total of 104 patients with septic shock admitted to ICU of Affiliated Hai'an Hospital of Nantong University from February 2018 to June 2021 were selected for clinical research. According to the survival situation of patients after 28 days of treatment, they were divided into the death group (n = 48) and the survival group (n = 56). The central venous-arterial carbon dioxide partial pressure difference (Pcv-aCO2), the ratio of central venous-arterial carbon dioxide partial pressure difference to arterial central venous oxygen content difference (Pcv-aCO2/Ca-cvO2), and blood lactic acid level were retrospectively analyzed and compared between the two groups on the first, third, and seventh days after admission to ICU. The odds ratio (OR) of three indexes affecting the prognosis of patients with septic shock was analyzed by univariate and multivariate mathematical models, and the value of three indexes in predicting the prognosis of patients was analyzed by receiver operating curve (ROC).

Results: Pcv-aCO2 and lactic acid in the death group were higher than those in the survival group on the 1st, 3rd, and 7th day of ICU stay (P < 0.05). The Pcv-aCO2/Ca-cvO2 of the death group was higher than that of the survival group on the 3rd and 7th day of ICU stay (P < 0.05). Logistic model results showed that age, SOFA score, APACHE II score, the number of multiple organ failure (MODS), intracranial infection, the increase of Pcv-aCO2, Pcv-aCO2/Ca-cvO2, and the increase of lactic acid were independent risk factors for death in patients with septic shock (OR values were 1.519, 1.808, 1.781, 1.912, 2.069, 1.848, 1.781, and 1.642, respectively, P < 0.05). The results showed that the AUC value of Pcv-aCO2 in predicting death was 0.943, and the sensitivity and specificity were 93.72% and 83.09%, respectively. The AUC value of Pcv-aCO2/Ca-cvO2 for predicting death was 0.887, and the sensitivity and specificity were 81.63% and 77.56%, respectively. The AUC value of lactic acid in predicting death of patients was 0.825, and the sensitivity and specificity were 71.66% and 82.09%, respectively.

Conclusion: Changes of microcirculation flow tissue perfusion parameters and blood lactic acid level changes are closely related to the prognosis of patients with septic shock, which is of great value in the evaluation of the prognosis of patients with septic shock.

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Conflict of interest statement

The authors declared that they have no conflicts of interest regarding this work.

Figures

Figure 1
Figure 1
ROC curve of Pcv-aCO2, Pcv-aCO2/Ca-cvO2, and lactate values in predicting the death of patients.
See this image and copyright information in PMC

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References

    1. Silva P., Fonseca M. High-dose vasopressor therapy for pediatric septic shock: when is too much? Journal of Pediatric Intensive Care . 2020;9(3):172–180. - PMC - PubMed
    1. Wang W., Yang Y. P., Tasneem S., et al. Lanostane tetracyclic triterpenoids as important sources for anti-inflammatory drug discovery. World J Tradit Chin Med . 2020;6(3):229–238. doi: 10.4103/wjtcm.wjtcm_17_20. - DOI
    1. Inghammar M., Sunden-Cullberg J. Prognostic significance of body temperature in the emergency department vs the ICU in Patients with severe sepsis or septic shock: a nationwide cohort study. PLoS One . 2020;15(12) doi: 10.1371/journal.pone.0243990.e0243990 - DOI - PMC - PubMed
    1. Jeremy W., Michael K., Chanu R. What Is the utility of measuring lactate levels in patients with sepsis and septic shock? Seminars in Respiratory and Critical Care Medicine . 2021;42(5):650–661. - PubMed
    1. Vliegen G., Kehoe K., Bracke A., et al. Dysregulated activities of proline-specific enzymes in septic shock patients (sepsis-2) PLoS One . 2020;15(4) doi: 10.1371/journal.pone.0231555.e0231555 - DOI - PMC - PubMed

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