Central venous oxygen saturation changes as a reliable predictor of the change of CI in septic shock:To explore potential influencing factors  

作　　者：Ran An Xi-Xi Wan Yan Chen Run Dong Chun-Yao Wang Wei Jiang Li Weng Bin Du 

机构地区：[1]Medical Intensive Care Unit,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing,100730,China [2]Department of Critical Care Medicine,The Second Affiliated Hospital of Jiaxing University,Jiaxing,314001,Zhejiang province,China

出　　处：《Chinese Journal of Traumatology》2025年第1期43-49,共7页中华创伤杂志(英文版)

基　　金：National Key R&D Program of China from the Ministry of Science and Technology of the People''s Republic of China(2021YFC2500801, 2022YFC2304601);CAMS Innovation Fund for Medical Sciences (CIFMS) 2021-I2M-1-062 from the Chinese Academy of Medical Sciences;National High-Level Hospital Clinical Research Funding(2022-PUMCH-D-005, 2022-PUMCH-B111);National key clinical specialty construction projects from the National Health Commission

摘　　要：Purpose:Assessing fluid responsiveness relying on central venous oxygen saturation(ScvO_(2))yields varied outcomes across several studies.This study aimed to determine the ability of the change in ScvO_(2)(ΔScvO_(2))to detect fluid responsiveness in ventilated septic shock patients and potential influencing factors.Methods:In this prospective,single-center study,all patients conducted from February 2023 to January 2024 received fluid challenge.Oxygen consumption was measured by indirect calorimetry,and fluid responsiveness was defined as an increase in cardiac index(CI)≥10%measured by transthoracic echocardiography.Multivariate linear regression analysis was conducted to evaluate the impact of oxygen consumption,arterial oxygen saturation,CI,and hemoglobin on ScvO_(2)and its change before and after fluid challenge.The Shapiro-Wilk test was used for the normality of continuous data.Data comparison between fluid responders and non-responders was conducted using a two-tailed Student t-test,Mann Whitney U test,and Chi-square test.Paired t-tests were used for normally distributed data,while the Wilcoxon signed-rank test was used for skewed data,to compare data before and after fluid challenge.Results:Among 49 patients(31 men,aged(59±18)years),27 were responders.The patients had an acute physiology and chronic health evaluation II score of 24±8,a sequential organ failure assessment score of 11±4,and a blood lactate level of(3.2±3.1)mmol/L at enrollment.After the fluid challenge,theΔScvO_(2)(mmHg)in the responders was greater than that in the non-responders(4±6 vs.1±3,p=0.019).Multivariate linear regression analysis suggested that CI was the only independent influencing factor of ScvO_(2),with R2=0.063,p=0.008.After the fluid challenge,the change in CI became the only contributing factor toΔScvO_(2)(R2=0.245,p<0.001).ΔScvO_(2)had a good discriminatory ability for the responders and non-responders with a threshold of 4.4%(area under the curve=0.732,p=0.006).Conclusion:ΔScvO_(2)served as a reliable surrogate

关 键 词：Septicshock ScvO_(2) Fluid responsiveness 

分 类 号：R459.7[医药卫生—急诊医学]