The role of end-tidal carbon dioxide partial pressure in fluid responsiveness assessment in septic shock patient / 中华内科杂志

ABSTRACT

Objective To assess whether end-tidal carbon dioxide partial pressure (PET CO2) can predict the fluid responsiveness in septic shock patients.Methods Septic shock patients under mechanical ventilation without spontaneous breathing and with the need of a fluid challenge test were included in this study.Heart rate,central venous pressure,pulse pressure,PErCO2,and CI before and after the fluid challenge test were conducted in all the patients.Results Of the 48 septic shock patients included,34 had preload responsiveness,14 had no responsiveness.△CI and △PET CO2 after the fluid challenge test involume responders were (0.85 ± 0.47) L · min-1 · m-2 and (3.5 ± 2.5) mmHg respectively,which were higher than those in no volume responders (P ＜ 0.05).The fluid-induced changes in PET CO2 and CI were correlated (r =0.072,P ＜ 0.05).The AUCRoc of fluid challenge-induced △PET CO2 as the predictor for volume responsiveness was 0.943,and its sensitivity was 87.9％ and specificity was 93.4％ with a critical value of 5％.The AUCRoc of △PP as the predictor for volume responsiveness was 0.801,and its sensitivity was 68.1％ and specificity was 73.2％ with a critical value of 10％.Conclusion The changes of PETCO2 induced by a fluid challenge test can predict fluid responsiveness with reliability,and have a better sensitivity and specificity than the changes of PP.