重庆医学2013，Vol.42Issue(7)：729-731,3.DOI:10.3969/j.issn.1671-8348.2013.07.004
中心静脉-动脉血二氧化碳分压差对感染性休克液体复苏指导作用的研究
Effect of central venous-to-arterial blood carbon dioxide partial pressure difference in guiding fluid resuscitation of septic shock
余国宝 1袁宁 1刘毅 1张利娜 2黄立 2艾宇航2
作者信息
- 1. 萍矿总医院重症医学科,江西萍乡,337000
- 2. 中南大学湘雅医院重症医学科,长沙,410008
- 折叠
摘要
Abstract
Objective To evaluate the significance of carbon dioxide partial pressure difference in central vein arterial blood[P (cv a)CO2] as an indicator in guiding the fluid resuscitation of septic shock. Methods Of 128 patients with septic shock treated in ICU of the General Hospital of Pingxiang Mining Group,68 cases were selected and randomly divided into 2 groups. The group A (ScvO2 ,30 cases) maintained the central venous pressure(CVP) 8 — 12 mm Hg,the mean arterial pressure(MAP) 65 — 90 mm Hg, ScvO2≥70% and the urine volume≥0. 5 mL · kg-1 · h-1 for 6 h treatment. The group B[ScvO2+P(cv a)CO2,38 cases] main tained CVP 8—12 mm Hg,MAP 65 — 90 mm Hg, ScvO2 ≥70% , the urine volume≥0. 5 mL · kg-1 · h-1 and P(cv a)CO2< 6 mm Hg for 6 h treatment. The effects were compared between the two groups. Results The lactic acid clearance rate,CI,ScvO2 , CVP and the fluid balance after 6 h fluid resuscitation in the group B were higher than those in the group A(P<0. 05). The dosages of vasoactive agent dobutamine and norepinephrine were higher than those in the group B(P<0. 05). Conclusion Using P(cv a) CO2 to guide the fluid resuscitation in the patients with septic shock may better evaluate the effective circulating blood flow volume and tissue perfusion status,and also is a sensitive index for judging the severity degree of septic shock,treatment effect and prognosis.关键词
感染性休克/液体复苏/中心静脉压/二氧化碳分压测定Key words
rseptic shock/ fluid resuscitation/ central venous pressure/ carbon dioxide partial pressure determination引用本文复制引用
余国宝,袁宁,刘毅,张利娜,黄立,艾宇航..中心静脉-动脉血二氧化碳分压差对感染性休克液体复苏指导作用的研究[J].重庆医学,2013,42(7):729-731,3.
