Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure

IF 0.3 Q4 CRITICAL CARE MEDICINE

Egyptian Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI:10.1016/j.ejccm.2017.03.001

Randa Soliman

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引用次数: 7

Abstract

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.

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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

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。背景:脓毒性血流动力学不稳定给重症监护医生在决定流体管理以优化负荷前依赖状态方面提出了挑战。方法30例严重脓毒症合并低血压患者(平均动脉压MAP <65 mmHg)和组织低血压的证据，即乳酸水平≥4 mmol/L纳入我们的研究。给予液体复苏(30ml /kg)。液体反应定义为MAP≥65 mmHg，并通过心电测量测量乳酸水平和4 mmol/L心输出量(CO)，以指导液体治疗。结果男性13例(43.3%)，年龄47.8±19.7岁。配对比较显示MAP读数有显著变化(P值<0.001)。ROC曲线显示δ CO预测流体反应性的截断值为12.5%，曲线下面积(AUC)为0.927，敏感性90.0%，特异性70.0%。ROC还显示δ CO截断12.5%预测生存，AUC为0.756，敏感性66.7%，特异性66.7%。结论心电测量心输出量δ变化可用于预测脓毒症危重患者急性循环衰竭时的液体反应和生存。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Egyptian Journal of Critical Care Medicine

自引率

0.00%

发文量

审稿时长

42 weeks

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.