Clinical value of venous-arterial carbon dioxide partial pressure difference combined with venous oxygen saturation monitoring in patients with septic shock
NI Shi-jiao
Department of Internal Medicine, Jingdezhen Second People′s Hospital
Abstract： Objective To explore the clinical value of venous-arterial carbon dioxide partial pressure difference (P[cva]CO2) and venous oxygen saturation（ScvO2） monitoring in septic shock.Methods From October 2018 to October 2020,86 patients with septic shock admitted to Jingdezhen Second People′s Hospital, Jiangxi Province were selected as the research objects.They were divided into the control group （43 cases） and the treatment group （43 cases） using random number table method.Patients in the control group used ScvO2 level as the guiding target for fluid resuscitation, Pa tients in the treatment group used the individual ScvO2 level combined with P(cv-a)CO2 level as the guiding target for fluid resuscitation.Patients in both groups were continuously observed for 28 days after fluid resuscitation for 6 hours.the treatment of the two groups of patients, physiological indicators, lactic acid clearance rate and prognosis before fluid resuscitation and 6 hours after fluid resuscitation were compared.Results The length of stay in the treatment group was shorter than that of the control group, and the difference was statistically significant （P＜0.05）; the dosage of Nore pinephrine of the treatment group was less than that of the control group, and the difference was statistically significant（P＜0.05）.After 6 hours of resuscitation, the central venous pressure （CVP）, mean arterial pressure （MAP）, and ScvO2 levels of the two groups were higher than those before resuscitation, and the CVP, ScvO2 levels and lactate clearance rate of the treatment group were higher than those of the control group, and the differences were statistically significant（P＜0.05）.There was no statistically significant difference in MAP level between the two groups of patients after 6 hours of fluid resuscitation （P＞0.05）; the differences in the incidence of pulmonary edema and mortality within 28 days between the two groups were not statistically significant （P＞0.05）.Conclusion P（cv-a）CO2 combined with ScvO2 is used as a monitoring indicator to guide patients with septic shock to perform fluid resuscitation,which can effectively improve the quality of fluid resuscitation, improve the treatment effect, shorten the hospital stay, reduce the amount of related medications, and the incidence of pulmonary edema after fluid resuscitation no increase, good security.
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