{"title":"组织灌注指数在预测严重和危重 COVID-19 患者的疾病严重程度和预后中的作用。","authors":"Wan-Ting Lin, Yan-Jie Zhang, Ming-Kun Yan, Xiao-Tian Cai, Xin-Er Cai, Jingyuan Xu","doi":"10.1177/08850666241253162","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The study investigated whether percutaneous partial pressure of oxygen (PtcO<sub>2</sub>), percutaneous partial pressure of carbon dioxide (PtcCO<sub>2</sub>), and the derived tissue perfusion index (TPI) can predict the severity and short-term outcomes of severe and critical COVID-19.</p><p><strong>Design: </strong>Prospective observational study conducted from January 1, 2023 to February 10, 2023.</p><p><strong>Setting: </strong>A teaching hospital specializing in tertiary care in Nanjing City, Jiangsu Province, China.</p><p><strong>Participants: </strong>Adults (≥18 years) with severe and critical COVID-19.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The general information and vital signs of the patients were collected. The PtcO<sub>2</sub> and PtcCO<sub>2</sub> were monitored in the left dorsal volar. The ratio of TPI was defined as the ratio of PtcO<sub>2</sub>/fraction of inspired oxygen (FiO<sub>2</sub>) to PtcCO<sub>2</sub>. Mortality at 28 was recorded. The ability of the TPI to assess disease severity and predict prognosis was determined.</p><p><strong>Endpoint: </strong>Severity of the disease on the enrollment and mortality at 28.</p><p><strong>Results: </strong>A total of 71 patients with severe and critical COVID-19, including 40 severe and 31 critical cases, according to the COVID-19 treatment guidelines published by WHO, were recruited. Their median age was 70 years, with 56 (79%) males. The median SpO<sub>2</sub>/FiO<sub>2</sub>, PtcO<sub>2</sub>, PtcCO<sub>2</sub>, PtcO<sub>2</sub>/ FiO<sub>2</sub>, and TPI values were 237, 61, 42, 143, and 3.6 mm Hg, respectively. Compared with those for severe COVID-19, the TPI, PtcO<sub>2</sub>/ FiO<sub>2</sub>, SpO<sub>2</sub>/FiO<sub>2,</sub> and PtcO<sub>2</sub> were significantly lower in critical COVID-19, while the PtcCO<sub>2</sub> was significantly higher. After 28 days, 26 (37%) patients had died. TPI values < 3.5 were correlated with more severe disease status (AUC 0.914; 95% CI: 0.847-0.981, P < 0.001), and TPI < 3.3 was associated with poor outcomes (AUC 0.937; 95% CI 0.880-0.994, P < 0.001).</p><p><strong>Conclusions: </strong>The tissue perfusion index (TPI), PtcCO<sub>2</sub>, and PtcO<sub>2</sub>/ FiO<sub>2</sub> can predict the severity and outcome of severe and critical COVID-19.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1212-1220"},"PeriodicalIF":3.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Role of the Tissue Perfusion Index in Predicting Disease Severity and Prognosis in Patients with Severe and Critical COVID-19.\",\"authors\":\"Wan-Ting Lin, Yan-Jie Zhang, Ming-Kun Yan, Xiao-Tian Cai, Xin-Er Cai, Jingyuan Xu\",\"doi\":\"10.1177/08850666241253162\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The study investigated whether percutaneous partial pressure of oxygen (PtcO<sub>2</sub>), percutaneous partial pressure of carbon dioxide (PtcCO<sub>2</sub>), and the derived tissue perfusion index (TPI) can predict the severity and short-term outcomes of severe and critical COVID-19.</p><p><strong>Design: </strong>Prospective observational study conducted from January 1, 2023 to February 10, 2023.</p><p><strong>Setting: </strong>A teaching hospital specializing in tertiary care in Nanjing City, Jiangsu Province, China.</p><p><strong>Participants: </strong>Adults (≥18 years) with severe and critical COVID-19.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The general information and vital signs of the patients were collected. The PtcO<sub>2</sub> and PtcCO<sub>2</sub> were monitored in the left dorsal volar. The ratio of TPI was defined as the ratio of PtcO<sub>2</sub>/fraction of inspired oxygen (FiO<sub>2</sub>) to PtcCO<sub>2</sub>. Mortality at 28 was recorded. The ability of the TPI to assess disease severity and predict prognosis was determined.</p><p><strong>Endpoint: </strong>Severity of the disease on the enrollment and mortality at 28.</p><p><strong>Results: </strong>A total of 71 patients with severe and critical COVID-19, including 40 severe and 31 critical cases, according to the COVID-19 treatment guidelines published by WHO, were recruited. Their median age was 70 years, with 56 (79%) males. The median SpO<sub>2</sub>/FiO<sub>2</sub>, PtcO<sub>2</sub>, PtcCO<sub>2</sub>, PtcO<sub>2</sub>/ FiO<sub>2</sub>, and TPI values were 237, 61, 42, 143, and 3.6 mm Hg, respectively. Compared with those for severe COVID-19, the TPI, PtcO<sub>2</sub>/ FiO<sub>2</sub>, SpO<sub>2</sub>/FiO<sub>2,</sub> and PtcO<sub>2</sub> were significantly lower in critical COVID-19, while the PtcCO<sub>2</sub> was significantly higher. After 28 days, 26 (37%) patients had died. TPI values < 3.5 were correlated with more severe disease status (AUC 0.914; 95% CI: 0.847-0.981, P < 0.001), and TPI < 3.3 was associated with poor outcomes (AUC 0.937; 95% CI 0.880-0.994, P < 0.001).</p><p><strong>Conclusions: </strong>The tissue perfusion index (TPI), PtcCO<sub>2</sub>, and PtcO<sub>2</sub>/ FiO<sub>2</sub> can predict the severity and outcome of severe and critical COVID-19.</p>\",\"PeriodicalId\":16307,\"journal\":{\"name\":\"Journal of Intensive Care Medicine\",\"volume\":\" \",\"pages\":\"1212-1220\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Intensive Care Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/08850666241253162\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/15 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Intensive Care Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/08850666241253162","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/15 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
The Role of the Tissue Perfusion Index in Predicting Disease Severity and Prognosis in Patients with Severe and Critical COVID-19.
Objectives: The study investigated whether percutaneous partial pressure of oxygen (PtcO2), percutaneous partial pressure of carbon dioxide (PtcCO2), and the derived tissue perfusion index (TPI) can predict the severity and short-term outcomes of severe and critical COVID-19.
Design: Prospective observational study conducted from January 1, 2023 to February 10, 2023.
Setting: A teaching hospital specializing in tertiary care in Nanjing City, Jiangsu Province, China.
Participants: Adults (≥18 years) with severe and critical COVID-19.
Interventions: Not applicable.
Main outcome measures: The general information and vital signs of the patients were collected. The PtcO2 and PtcCO2 were monitored in the left dorsal volar. The ratio of TPI was defined as the ratio of PtcO2/fraction of inspired oxygen (FiO2) to PtcCO2. Mortality at 28 was recorded. The ability of the TPI to assess disease severity and predict prognosis was determined.
Endpoint: Severity of the disease on the enrollment and mortality at 28.
Results: A total of 71 patients with severe and critical COVID-19, including 40 severe and 31 critical cases, according to the COVID-19 treatment guidelines published by WHO, were recruited. Their median age was 70 years, with 56 (79%) males. The median SpO2/FiO2, PtcO2, PtcCO2, PtcO2/ FiO2, and TPI values were 237, 61, 42, 143, and 3.6 mm Hg, respectively. Compared with those for severe COVID-19, the TPI, PtcO2/ FiO2, SpO2/FiO2, and PtcO2 were significantly lower in critical COVID-19, while the PtcCO2 was significantly higher. After 28 days, 26 (37%) patients had died. TPI values < 3.5 were correlated with more severe disease status (AUC 0.914; 95% CI: 0.847-0.981, P < 0.001), and TPI < 3.3 was associated with poor outcomes (AUC 0.937; 95% CI 0.880-0.994, P < 0.001).
Conclusions: The tissue perfusion index (TPI), PtcCO2, and PtcO2/ FiO2 can predict the severity and outcome of severe and critical COVID-19.
期刊介绍：
Journal of Intensive Care Medicine (JIC) is a peer-reviewed bi-monthly journal offering medical and surgical clinicians in adult and pediatric intensive care state-of-the-art, broad-based analytic reviews and updates, original articles, reports of large clinical series, techniques and procedures, topic-specific electronic resources, book reviews, and editorials on all aspects of intensive/critical/coronary care.
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