Correlation between pressure and volume parameters of septic shock patients with cardiac depression / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the characteristics and influence of cardiac depression on patients with septic shock.</p><p><b>METHODS</b>Seventy seven septic shock patients treated from January 2005 to June 2009 were retrospectively studied, they were divided into two groups based on cardiac index (CI) after early resuscitation, high CI group CI >/= 3 L/(min.m(2)), low CI group CI < 3 L/(min.m(2)). Rate of goal achievement, prognosis and whether the global end diastolic volume index (GEDI) increases with central venous pressure (CVP) growth of the two groups were compared.</p><p><b>RESULTS</b>There were 38 patients in the low CI group, and 39 patients in the high CI group. Compared with patients in the high CI group, patients in the low CI group had older age and higher APACHE II score (P < 0.05). Compared with patients in the high CI group, patients in the low CI group had higher mortality rate and lower rate of goal achievement (P < 0.05). In low CI group, 16 patients' GEDI didn't increase with CVP growth, and in high CI group only 6 patients' GEDI didn't increase with CVP growth (P < 0.05); In low CI group, patients whose GEDI didn't increase with CVP growth had higher arterial lactate, lower ScvO(2), lower rate of goal achievement and worse prognosis than patients whose GEDI increased with CVP growth(P < 0.05).</p><p><b>CONCLUSIONS</b>For septic shock patients, correlation between CVP and GEDI can reflect cardiac function. Especially for patients with low CI, GEDI doesn't increase with CVP growth is a signal of cardiac depression and can be an early indicator of worse prognosis. Older septic shock patients and those with higher APACHE II score tend to have the complication of cardiac depression.</p>