Xiaoqiang Bao, Qiuxiang Pan, Miaomiao Jiang, Lu Lu, Feng Li, Zhenhua Dong, Zhiheng Li
{"title":"桡动脉压平血压计与危重监护超声引导下脓毒症休克患者液体复苏预后的对比分析:回顾性队列先导研究。","authors":"Xiaoqiang Bao, Qiuxiang Pan, Miaomiao Jiang, Lu Lu, Feng Li, Zhenhua Dong, Zhiheng Li","doi":"10.1186/s12893-025-03000-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hemodynamic monitoring is crucial for guiding fluid resuscitation in patients with Septic shock (SS). Radial artery applanation tonometry (RAAT) is faster and easier to operate and has been developed and used for continuous arterial pressure monitoring. However, there is no empirical evidence to confirm its benefit in the treatment of SS. The aim of this study was to investigate the clinical efficacy of two non-invasive hemodynamic monitoring techniques, namely RAAT and critical care ultrasound (CCUS)-guided interventions, in the treatment of fluid resuscitation in SS.</p><p><strong>Methods: </strong>This single-center retrospective study included patients diagnosed with SS at our institution from 2021 to 2022. Patients were divided into two groups based on the hemodynamic monitoring method used: the RAAT group and the CCUS group. Twenty-eight-day mortality, intensive care unit (ICU) length of stay, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, incidence of renal failure, hemodynamic parameters, oxygenation index, Lac levels, Lac clearance, and procalcitoninogen (PCT) levels were assessed after fluid resuscitation in both groups.</p><p><strong>Results: </strong>A total of 78 patients were included in the study, with 41 in the RAAT group and 37 in the CCUS group. There were no significant differences in demographic and baseline characteristics between the two groups except for SOFA, heart rate, MAP. early outcomes including 28 day mortality, 48 h oxygenation index, PCT levels and Acute Physiology and Chronic Health Evaluation II score, ICU stay, infusion volume, and incidence of renal failure. There was no significant difference in metabolic and hemodynamic indexes of Lac, Lac clearance, CVP, and 48 h MAP, and there was a significant difference in 24 h MAP between the CCUS group [68 (65, 71)] and the RAAT group [71 (67, 75)], P = 0.008.</p><p><strong>Conclusion: </strong>In the fluid resuscitation of SS patients, the effects of the non-invasive hemodynamic monitoring methods RAAT and CCUS are comparable. In clinical application, the appropriate method can be selected according to the patient's specific situation, hospital resources, medical staff's proficiency and monitoring needs, or a combination of the two can be used in order to more comprehensively and accurately assess the patient's condition.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"262"},"PeriodicalIF":1.6000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative analysis of the prognosis of fluid resuscitation in sepsis shock patients guided by radial artery applanation tonometry and critical care ultrasound: a retrospective cohort pilot study.\",\"authors\":\"Xiaoqiang Bao, Qiuxiang Pan, Miaomiao Jiang, Lu Lu, Feng Li, Zhenhua Dong, Zhiheng Li\",\"doi\":\"10.1186/s12893-025-03000-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hemodynamic monitoring is crucial for guiding fluid resuscitation in patients with Septic shock (SS). Radial artery applanation tonometry (RAAT) is faster and easier to operate and has been developed and used for continuous arterial pressure monitoring. However, there is no empirical evidence to confirm its benefit in the treatment of SS. The aim of this study was to investigate the clinical efficacy of two non-invasive hemodynamic monitoring techniques, namely RAAT and critical care ultrasound (CCUS)-guided interventions, in the treatment of fluid resuscitation in SS.</p><p><strong>Methods: </strong>This single-center retrospective study included patients diagnosed with SS at our institution from 2021 to 2022. Patients were divided into two groups based on the hemodynamic monitoring method used: the RAAT group and the CCUS group. Twenty-eight-day mortality, intensive care unit (ICU) length of stay, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, incidence of renal failure, hemodynamic parameters, oxygenation index, Lac levels, Lac clearance, and procalcitoninogen (PCT) levels were assessed after fluid resuscitation in both groups.</p><p><strong>Results: </strong>A total of 78 patients were included in the study, with 41 in the RAAT group and 37 in the CCUS group. There were no significant differences in demographic and baseline characteristics between the two groups except for SOFA, heart rate, MAP. early outcomes including 28 day mortality, 48 h oxygenation index, PCT levels and Acute Physiology and Chronic Health Evaluation II score, ICU stay, infusion volume, and incidence of renal failure. There was no significant difference in metabolic and hemodynamic indexes of Lac, Lac clearance, CVP, and 48 h MAP, and there was a significant difference in 24 h MAP between the CCUS group [68 (65, 71)] and the RAAT group [71 (67, 75)], P = 0.008.</p><p><strong>Conclusion: </strong>In the fluid resuscitation of SS patients, the effects of the non-invasive hemodynamic monitoring methods RAAT and CCUS are comparable. In clinical application, the appropriate method can be selected according to the patient's specific situation, hospital resources, medical staff's proficiency and monitoring needs, or a combination of the two can be used in order to more comprehensively and accurately assess the patient's condition.</p>\",\"PeriodicalId\":49229,\"journal\":{\"name\":\"BMC Surgery\",\"volume\":\"25 1\",\"pages\":\"262\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12893-025-03000-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12893-025-03000-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景:血流动力学监测是指导脓毒性休克(SS)患者液体复苏的关键。桡动脉压平血压计(RAAT)是一种快速、简便的方法,已被广泛应用于动脉血压的连续监测。然而,尚无经验证据证实其在治疗SS中的益处。本研究的目的是探讨两种无创血流动力学监测技术,即RAAT和重症监护超声(CCUS)引导干预在SS液体复苏治疗中的临床疗效。方法:本研究为单中心回顾性研究,纳入我院2021 - 2022年诊断为SS的患者。根据采用的血流动力学监测方法将患者分为两组:RAAT组和CCUS组。对两组患者液体复苏后的28天死亡率、重症监护病房(ICU)住院时间、急性生理和慢性健康评估II (APACHE II)评分、肾功能衰竭发生率、血流动力学参数、氧合指数、Lac水平、Lac清除率和降钙素原(PCT)水平进行评估。结果:共纳入78例患者,其中RAAT组41例,CCUS组37例。两组间除SOFA、心率、MAP外,人口学和基线特征无显著差异。早期结局包括28天死亡率、48 h氧合指数、PCT水平、急性生理和慢性健康评估II评分、ICU住院时间、输液量和肾衰竭发生率。两组在Lac、Lac清除率、CVP、48 h MAP等代谢及血流动力学指标上均无显著差异,其中CCUS组[68(65,71)]与RAAT组[71(67,75)]在24 h MAP上有显著差异,P = 0.008。结论:在SS患者的液体复苏中,无创血流动力学监测方法RAAT与CCUS的效果具有可比性。在临床应用中,可以根据患者的具体情况、医院资源、医务人员的熟练程度和监测需要选择合适的方法,或者两者结合使用,以便更全面、准确地评估患者的病情。
Comparative analysis of the prognosis of fluid resuscitation in sepsis shock patients guided by radial artery applanation tonometry and critical care ultrasound: a retrospective cohort pilot study.
Background: Hemodynamic monitoring is crucial for guiding fluid resuscitation in patients with Septic shock (SS). Radial artery applanation tonometry (RAAT) is faster and easier to operate and has been developed and used for continuous arterial pressure monitoring. However, there is no empirical evidence to confirm its benefit in the treatment of SS. The aim of this study was to investigate the clinical efficacy of two non-invasive hemodynamic monitoring techniques, namely RAAT and critical care ultrasound (CCUS)-guided interventions, in the treatment of fluid resuscitation in SS.
Methods: This single-center retrospective study included patients diagnosed with SS at our institution from 2021 to 2022. Patients were divided into two groups based on the hemodynamic monitoring method used: the RAAT group and the CCUS group. Twenty-eight-day mortality, intensive care unit (ICU) length of stay, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, incidence of renal failure, hemodynamic parameters, oxygenation index, Lac levels, Lac clearance, and procalcitoninogen (PCT) levels were assessed after fluid resuscitation in both groups.
Results: A total of 78 patients were included in the study, with 41 in the RAAT group and 37 in the CCUS group. There were no significant differences in demographic and baseline characteristics between the two groups except for SOFA, heart rate, MAP. early outcomes including 28 day mortality, 48 h oxygenation index, PCT levels and Acute Physiology and Chronic Health Evaluation II score, ICU stay, infusion volume, and incidence of renal failure. There was no significant difference in metabolic and hemodynamic indexes of Lac, Lac clearance, CVP, and 48 h MAP, and there was a significant difference in 24 h MAP between the CCUS group [68 (65, 71)] and the RAAT group [71 (67, 75)], P = 0.008.
Conclusion: In the fluid resuscitation of SS patients, the effects of the non-invasive hemodynamic monitoring methods RAAT and CCUS are comparable. In clinical application, the appropriate method can be selected according to the patient's specific situation, hospital resources, medical staff's proficiency and monitoring needs, or a combination of the two can be used in order to more comprehensively and accurately assess the patient's condition.