Predictive value and correlation analysis of hemodynamic parameters on volume responsiveness in patients with septic shock
Objective To analyze the predictive value and correlation of hemodynamic parameters on volume responsiveness in patients with septic shock.Methods A total of 98 patients with septic shock admitted in our hospital from January 2021 to May 2023 were selected as the research objects.According to whether the stroke volume(SV)changes of patients before and after rehydration test were≥ 15％,and the patients were divided into positive group and negative group.The general data,pulse indicated continuous cardiac output(PICCO)indexes and echocardiographic indexes of the two groups were obtained and compared.The receiver operating characteristic(ROC)curve and multivariate Logistic regression model were used to analyze the predictive value and correlation of hemodynamic parameters on volume responsiveness in patients with septic shock.Results Among the 98 patients,53 were positive for volume responsiveness and 45 were negative;the scores of Acute Physiology and Chronic Health Evaluation Score Ⅱ(APACHE Ⅱ)and Sequential Organ Failure Assessment(SOFA)in the positive group were lower than those in the negative group(P＜0.05).After the test,the heart rate(HR)and stroke volume variation(SVV)of the positive group were lower than those of the negative group,and the cardiac output(CO),cardiac index(CI)and central venous pressure(CVP)were higher than those of the negative group(P＜0.05).After the test,the velocity time integral(VTI)of the positive group was higher than that of the negative group,and the peak flow respiratory variation(Vpeak)was lower than that of the negative group(P＜0.05).The results of ROC curve showed that the areas under curve(AUC)of HR,CO,CI,CVP,SVV,VTI and Vpeak for predicting positive fluid responsiveness in patients with septic shock were 0.515,0.560,0.556,0.499,0.898,0.922 and 0.912,respectively.The results of multivariate Logistic regression model showed that APACHE Ⅱ,SOFA scores,CO,CI,CVP,SVV,VTI and Vpeak were independent influencing factors of volume responsiveness in patients with septic shock(P＜0.05).Conclusion Closely monitoring the hemodynamic parameters of patients with septic shock has important clinical value for predicting the volume responsiveness of patients.
万方数据
维普
