{"title":"早期目标定向治疗(EGDT)治疗严重脓毒症和感染性休克患者ScvO2、血清乳酸、标准碱过量和阴离子间隙变化趋势的相关性:一项前瞻性观察研究","authors":"Kumari Sneha, Vanita Ramesh Mhaske, Kalyan Kumar Saha, Bikram Kumar Gupta, Dinesh Kumar Singh","doi":"10.4103/aer.aer_52_21","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>To observe the correlation of central venous oxygen saturation (ScvO<sub>2</sub>), serum lactate, standard base excess (SBE), and anion gap (AG) in septic and septic shock patients resuscitated with early goal-directed therapy (EGDT).</p><p><strong>Materials and methods: </strong>A review was made of 130 severe septic shock patients (15-65 years) according to the consensus conference criteria admitted in intensive care unit. Blood samples were obtained from arterial and central venous line for ScvO<sub>2,</sub> serum lactate, SBE, and AG on admission and after achieving all aims of EGDT i.e.; mean arterial pressure >65 mmHg, central venous pressure = 8-12 mmHg, ScvO<sub>2</sub> >70%, and urine output >0.5 mL.kg<sup>-1</sup>.h<sup>-1</sup>, and on 12 and 24 h. The statistical analysis was done using SPSS for windows version 16 software. For comparison, Pearson test was used. A <i>P</i> < 0.05 was considered as statistically significant.</p><p><strong>Results: </strong>There were a positive correlation between ScvO<sub>2</sub> and SBE, a negative correlation between ScvO<sub>2</sub> and AG, a negative correlation between ScvO<sub>2</sub> and lactate, a negative correlation between SBE and AG, a negative correlation between AG and lactate, and a negative correlation between SBE and lactate. The ScvO<sub>2</sub> was initially low but was in an improving trend after a resuscitative period, SBE was initially low and correction of SBE was linear. AG was high in the beginning and goes on decreasing after resuscitation. Lactate level was also high initially and in decreasing trend after a resuscitative period.</p><p><strong>Conclusions: </strong>ScvO<sub>2</sub> and SBE are correlated and can be used as a surrogate marker. ScvO<sub>2</sub> and AG are related but not absolutely codependent. ScvO<sub>2</sub> and lactate are correlated but they are not absolutely codependent. SBE and AG are correlated and can be used as a surrogate marker. AG and lactate are not related to each other. Hence, AG cannot be considered as a surrogate for lactate testing. SBE and lactate are related and can be used as a surrogate marker.</p>","PeriodicalId":7798,"journal":{"name":"Anesthesia, Essays and Researches","volume":"16 2","pages":"272-277"},"PeriodicalIF":0.0000,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701330/pdf/","citationCount":"1","resultStr":"{\"title\":\"Correlation of the Changing Trends of ScvO<sub>2</sub>, Serum Lactate, Standard Base Excess and Anion Gap in Patients with Severe Sepsis and Septic Shock Managed by Early Goal Directed Therapy (EGDT): A Prospective Observational Study.\",\"authors\":\"Kumari Sneha, Vanita Ramesh Mhaske, Kalyan Kumar Saha, Bikram Kumar Gupta, Dinesh Kumar Singh\",\"doi\":\"10.4103/aer.aer_52_21\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>To observe the correlation of central venous oxygen saturation (ScvO<sub>2</sub>), serum lactate, standard base excess (SBE), and anion gap (AG) in septic and septic shock patients resuscitated with early goal-directed therapy (EGDT).</p><p><strong>Materials and methods: </strong>A review was made of 130 severe septic shock patients (15-65 years) according to the consensus conference criteria admitted in intensive care unit. Blood samples were obtained from arterial and central venous line for ScvO<sub>2,</sub> serum lactate, SBE, and AG on admission and after achieving all aims of EGDT i.e.; mean arterial pressure >65 mmHg, central venous pressure = 8-12 mmHg, ScvO<sub>2</sub> >70%, and urine output >0.5 mL.kg<sup>-1</sup>.h<sup>-1</sup>, and on 12 and 24 h. The statistical analysis was done using SPSS for windows version 16 software. For comparison, Pearson test was used. A <i>P</i> < 0.05 was considered as statistically significant.</p><p><strong>Results: </strong>There were a positive correlation between ScvO<sub>2</sub> and SBE, a negative correlation between ScvO<sub>2</sub> and AG, a negative correlation between ScvO<sub>2</sub> and lactate, a negative correlation between SBE and AG, a negative correlation between AG and lactate, and a negative correlation between SBE and lactate. The ScvO<sub>2</sub> was initially low but was in an improving trend after a resuscitative period, SBE was initially low and correction of SBE was linear. AG was high in the beginning and goes on decreasing after resuscitation. Lactate level was also high initially and in decreasing trend after a resuscitative period.</p><p><strong>Conclusions: </strong>ScvO<sub>2</sub> and SBE are correlated and can be used as a surrogate marker. ScvO<sub>2</sub> and AG are related but not absolutely codependent. ScvO<sub>2</sub> and lactate are correlated but they are not absolutely codependent. SBE and AG are correlated and can be used as a surrogate marker. AG and lactate are not related to each other. Hence, AG cannot be considered as a surrogate for lactate testing. SBE and lactate are related and can be used as a surrogate marker.</p>\",\"PeriodicalId\":7798,\"journal\":{\"name\":\"Anesthesia, Essays and Researches\",\"volume\":\"16 2\",\"pages\":\"272-277\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701330/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anesthesia, Essays and Researches\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/aer.aer_52_21\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/10/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anesthesia, Essays and Researches","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/aer.aer_52_21","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/10/21 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
摘要
背景:观察采用早期目标定向治疗(EGDT)复苏的脓毒症和脓毒症休克患者中心静脉氧饱和度(ScvO2)、血清乳酸、标准碱过量(SBE)和阴离子间隙(AG)的相关性。材料与方法:对重症监护病房收治的130例15 ~ 65岁重症感染性休克患者进行回顾性分析。入院时和达到EGDT的所有目标后，从动脉和中心静脉线采集血液样本，检测ScvO2、血清乳酸、SBE和AG;平均动脉压>65 mmHg，中心静脉压= 8-12 mmHg, ScvO2 >70%，尿量>0.5 mL.kg-1.h-1，分别于12和24 h。统计学分析采用SPSS for windows version 16软件。比较采用Pearson检验。P < 0.05为差异有统计学意义。结果:ScvO2与SBE呈正相关，ScvO2与AG呈负相关，ScvO2与乳酸呈负相关，SBE与AG呈负相关，AG与乳酸呈负相关，SBE与乳酸呈负相关。ScvO2初始较低，复苏后呈改善趋势，SBE初始较低，SBE的修正呈线性。AG开始时较高，复苏后呈下降趋势。乳酸水平初期也较高，复苏后呈下降趋势。结论:ScvO2与SBE有相关性，可作为替代指标。ScvO2和AG是相关的，但不是绝对的相互依赖。ScvO2和乳酸是相关的，但它们不是绝对的相互依赖。SBE和AG具有相关性，可作为替代标记物。AG与乳酸不相关。因此，AG不能作为乳酸检测的替代。SBE与乳酸有相关性，可作为替代指标。
Correlation of the Changing Trends of ScvO2, Serum Lactate, Standard Base Excess and Anion Gap in Patients with Severe Sepsis and Septic Shock Managed by Early Goal Directed Therapy (EGDT): A Prospective Observational Study.
Background: To observe the correlation of central venous oxygen saturation (ScvO2), serum lactate, standard base excess (SBE), and anion gap (AG) in septic and septic shock patients resuscitated with early goal-directed therapy (EGDT).
Materials and methods: A review was made of 130 severe septic shock patients (15-65 years) according to the consensus conference criteria admitted in intensive care unit. Blood samples were obtained from arterial and central venous line for ScvO2, serum lactate, SBE, and AG on admission and after achieving all aims of EGDT i.e.; mean arterial pressure >65 mmHg, central venous pressure = 8-12 mmHg, ScvO2 >70%, and urine output >0.5 mL.kg-1.h-1, and on 12 and 24 h. The statistical analysis was done using SPSS for windows version 16 software. For comparison, Pearson test was used. A P < 0.05 was considered as statistically significant.
Results: There were a positive correlation between ScvO2 and SBE, a negative correlation between ScvO2 and AG, a negative correlation between ScvO2 and lactate, a negative correlation between SBE and AG, a negative correlation between AG and lactate, and a negative correlation between SBE and lactate. The ScvO2 was initially low but was in an improving trend after a resuscitative period, SBE was initially low and correction of SBE was linear. AG was high in the beginning and goes on decreasing after resuscitation. Lactate level was also high initially and in decreasing trend after a resuscitative period.
Conclusions: ScvO2 and SBE are correlated and can be used as a surrogate marker. ScvO2 and AG are related but not absolutely codependent. ScvO2 and lactate are correlated but they are not absolutely codependent. SBE and AG are correlated and can be used as a surrogate marker. AG and lactate are not related to each other. Hence, AG cannot be considered as a surrogate for lactate testing. SBE and lactate are related and can be used as a surrogate marker.
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