{"title":"用心电测量法预测脓毒症合并急性循环衰竭患者的体液状态和生存","authors":"Randa Soliman","doi":"10.1016/j.ejccm.2017.03.001","DOIUrl":null,"url":null,"abstract":"<div><p>Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure.</p></div><div><h3>Background</h3><p>Septic hemodynamic instability imposes challenges to critical care physician in deciding fluid management to optimize preload dependency state.</p></div><div><h3>Methods</h3><p>Thirty patients with severe sepsis and hypotension (Mean arterial pressure i.e. MAP<!--> <!--><<!--> <!-->65<!--> <!-->mmHg) and evidence of tissue hypotension i.e. lactate level ≥4<!--> <!-->mmol/L were enrolled in our study. Fluid resuscitation (30<!--> <!-->ml/kg) was administered. Fluid response was defined as MAP<!--> <!-->≥<!--> <!-->65<!--> <!-->mmHg with lactate level <4<!--> <!-->mmol/L cardiac output (CO), measured by electrical cardiometry, in guiding fluid therapy.</p></div><div><h3>Results</h3><p>The study included 13 males (43.3%) with age 47.8<!--> <!-->±<!--> <!-->19.7. Paired comparison showed significant change in MAP readings (P value<!--> <!--><<!--> <!-->0.001). ROC curve showed cutoff 12.5% for delta CO to predict fluid responsiveness with Area under Curve (AUC) 0.927, sensitivity 90.0%, and specificity 70.0%. ROC also showed delta CO cutoff 12.5% to predict survival with AUC 0.756, sensitivity 66.7% and specificity 66.7%.</p></div><div><h3>Conclusion</h3><p>Delta change in cardiac output, measured by electric cardiometry could be used to predict fluid response and survival in acute circulatory failure in septic critically ill patients.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"5 2","pages":"Pages 65-68"},"PeriodicalIF":0.3000,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.03.001","citationCount":"7","resultStr":"{\"title\":\"Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure\",\"authors\":\"Randa Soliman\",\"doi\":\"10.1016/j.ejccm.2017.03.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure.</p></div><div><h3>Background</h3><p>Septic hemodynamic instability imposes challenges to critical care physician in deciding fluid management to optimize preload dependency state.</p></div><div><h3>Methods</h3><p>Thirty patients with severe sepsis and hypotension (Mean arterial pressure i.e. MAP<!--> <!--><<!--> <!-->65<!--> <!-->mmHg) and evidence of tissue hypotension i.e. lactate level ≥4<!--> <!-->mmol/L were enrolled in our study. Fluid resuscitation (30<!--> <!-->ml/kg) was administered. Fluid response was defined as MAP<!--> <!-->≥<!--> <!-->65<!--> <!-->mmHg with lactate level <4<!--> <!-->mmol/L cardiac output (CO), measured by electrical cardiometry, in guiding fluid therapy.</p></div><div><h3>Results</h3><p>The study included 13 males (43.3%) with age 47.8<!--> <!-->±<!--> <!-->19.7. Paired comparison showed significant change in MAP readings (P value<!--> <!--><<!--> <!-->0.001). ROC curve showed cutoff 12.5% for delta CO to predict fluid responsiveness with Area under Curve (AUC) 0.927, sensitivity 90.0%, and specificity 70.0%. ROC also showed delta CO cutoff 12.5% to predict survival with AUC 0.756, sensitivity 66.7% and specificity 66.7%.</p></div><div><h3>Conclusion</h3><p>Delta change in cardiac output, measured by electric cardiometry could be used to predict fluid response and survival in acute circulatory failure in septic critically ill patients.</p></div>\",\"PeriodicalId\":31233,\"journal\":{\"name\":\"Egyptian Journal of Critical Care Medicine\",\"volume\":\"5 2\",\"pages\":\"Pages 65-68\"},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2017-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.03.001\",\"citationCount\":\"7\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Egyptian Journal of Critical Care Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2090730317300063\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Egyptian Journal of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2090730317300063","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure
Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure.
Background
Septic hemodynamic instability imposes challenges to critical care physician in deciding fluid management to optimize preload dependency state.
Methods
Thirty patients with severe sepsis and hypotension (Mean arterial pressure i.e. MAP < 65 mmHg) and evidence of tissue hypotension i.e. lactate level ≥4 mmol/L were enrolled in our study. Fluid resuscitation (30 ml/kg) was administered. Fluid response was defined as MAP ≥ 65 mmHg with lactate level <4 mmol/L cardiac output (CO), measured by electrical cardiometry, in guiding fluid therapy.
Results
The study included 13 males (43.3%) with age 47.8 ± 19.7. Paired comparison showed significant change in MAP readings (P value < 0.001). ROC curve showed cutoff 12.5% for delta CO to predict fluid responsiveness with Area under Curve (AUC) 0.927, sensitivity 90.0%, and specificity 70.0%. ROC also showed delta CO cutoff 12.5% to predict survival with AUC 0.756, sensitivity 66.7% and specificity 66.7%.
Conclusion
Delta change in cardiac output, measured by electric cardiometry could be used to predict fluid response and survival in acute circulatory failure in septic critically ill patients.
期刊介绍:
The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.