Clinical value of central venous Oxygen saturation in predicting fluid responsiveness in elderly patients with septic shock / 重庆医学

ABSTRACT

Objective To determine the predictive value of central venous oxygen saturation (ScvO2) in volume response by comparing the relationship between variation of ScvO2 and cardiac output (CO) variability before and after volume expansion in elderly patients with septic shock.Methods Forty-five patients who diagnosed septic shock were enrolled in the study,inserted CVC and were carried out continuous cardiac output monitoring(PICCO) before volume expansion.Every patient was treated by rapid intravenous infusion of 250 mL physiological saline,then take blood gas analysis before and after treated which the blood samples were collected from central venous catheter.The value of ScvO2 and the value of cardiac output was recorded.Degree of variation between two sets of data were tested by Student t-test.The correlation was determined by using Pearson's correlation test.Operating characteristics curve analysis was used to test their ability to distinguish R and NR.Results The mean arterial pressure (MAP)、heart rate(HR)、CO、ScvO2 were demonstrated and have statistical significance (P＜ 0.05) compared with before treated.CO and ScvO2 indexes were positively correlated (P＜0.01) before and after volume expansion.ScvO2 variations after VE were significantly correlated with CO changes after VE (r=0.781,P＜0.01).Conclusion ScvO2 dynamic changes can be used as a criterion for determining the fluid responsiveness.