Efficacy of non-invasive real-time arterial pressure and hemodynamic monitoring in surgical septic shock patients and its impact on stress response
Objective Exploring the application value of non-invasive real-time arterial pressure and hemodynamic monitoring in patients with surgical septic shock and its impact on stress response.Methods Selecting 46 patients with septic shock treated surgically in our hospital from September 2019 to March 2023 were selected,and a prospective randomized controlled plan was adopted,randomly divide the patients into two groups,with 23 cases in each group.The treatment group used non-invasive real-time ar-terial pressure and hemodynamic monitoring as the basis for treatment,while the control group used conven-tional monitoring treatment methods,Compare the expression levels of mean arterial pressure(MAP),cen-tral venous pressure(CVP),oxygenation index(PaO2/FiO2),central venous oxygen saturation(ScvO2),and lactate clearance rate between two groups at 6,12,and 24 h,respectively.Compare the differences in stress response between two groups of cortisol(Cor),epinephrine(E),and adrenocorticotropic hormone(ACTH)on the 1st,2nd,and 3rd day of surgical septic shock,respectively.Results The expression levels of MAP in the treatment group were higher than those in the control group at 6,12 and 24 h[(5.1± 1.8,8.0±1.6 and 10.2±1.3)vs.(4.5±1.9,5.2±1.8 and 8.4±1.3),t=21.345,17.625,15.235,P＜0.05];The expression levels of CVP in the treatment group were higher than those in the con-trol group at 6,12 and 24 h[(50.1±6.5,59.2±5.9 and 63.1±6.0)vs.(57.3±11.2,57.3±7.9 and 58.6±7.1),t=6.421,5.702,5.235,P＜0.05];The expression of PaO2/FiO2 in the treatment group was higher than that in the control group at 6,12 and 24 h[(247.4±11.2,311.2±8.7 and 335.0±8.5)vs.(212.5±10.5,284.2±10.2 and 301.2±8.7),t=15.302,12.211,11.357,P＜0.05];.The expression level of ScvO2 in the treatment group was higher than that in the control group at 6,12 and 24 h[(59.5±6.8,68.7±6.9 and 73.2±5.7)vs.(52.3±7.1,60.6±4.9 and 61.3±7.6),t=15.271,14.365,12.108,P＜0.05];The expression level of lactate clearance in the treatment group at 6,12 and 24 h was lower than that in the control group[(2.37±0.63,1.80±0.57 and 1.50±0.37),compared with(3.60±0.67,2.90±0.69 and 2.50±0.42,t=5.723,3.623,2.721,P＜0.05].The expression levels of Cor in the treatment group were lower than those in the control group on the first,sec-ond,and third day of surgical septic shock(310.51±25.53,359.38±26.96,400.41±27.85)vs.(340.35±27.09,390.56±35.88,430.45±36.74),t=14.041,16.415,18.107,respectively(P＜0.05).The results of the two comparisons showed that compared with the control group,the levels of relat-ed indicators in the treatment group patients decreased,and the difference between the groups was statisti-cally significant(P＜0.05).The expression levels of treatment group E were lower than those of the control group on the first,second,and third day of surgical septic shock(85.75±29.72,109.28±30.92,121.07±36.05)vs.(98.76±23.67,136.20±24.66,150.74±23.45),t=10.263,14.852,17.216,respectively,P＜0.05);The pairwise comparison results showed that compared with the control group E level,the treatment group patients had a lower level of related indicators,and the difference be-tween the groups was statistically significant(P＜0.05).The expression levels of ACTH in the treatment group were lower than those in the control group on the first,second,and third day of surgical septic shock(25.69±5.21,72.09±9.62,91.12±8.35)vs.(34.96±6.29,130.53±15.91,158.21±16.80,t=5.320,7.632,9.328,P＜0.05);The pairwise comparison results showed that compared with the ACTH level in the control group,the treatment group had a lower level of related indicators,and the differ-ence between the groups was statistically significant(P＜0.05).Conclusion The application of non-in-vasive real-time arterial pressure and hemodynamic monitoring in patients with septic shock,as well as the analysis of relevant mechanisms from the perspective of stress stress,can help patients achieve early targe-ted treatment and improve their prognosis.
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