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| The lactate clearance rate combined with venoarterial carbon dioxide difference to evaluate the prognosis of patients with septic shock |
| Cao Wen, Gao Xue-hua, Li Pei-jie, Luo Yan-nian, Wang Xue-ting, Lian Fo-yan, He Nan-nan, Guan Yin |
| Department of Critical Care Medicine, the Second Hospital of Lanzhou University, Lanzhou 730030, China |
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Abstract Objective: To explore the clinical value of the lactate clearance rate and venoarterial carbon dioxide difference in predicting the prognosis of the patients with septic shock. Methods: The clinical data of 103 patients with septic shock hospitalized at the MICU from January 2014 to June 2016 in the Second Hospital of Lanzhou University were collected. The patients underwent resuscitation through the requirements of the 2012 "for resuscitation of severe sepsis and septic shock patients were guide". The arterial blood lactic acid(Lac), central venous pressure of carbon dioxide(PcvCO2), arterial partial pressure of carbon dioxide(PaCO2)were measured before resuscitation(0 h)and at 6 h after resuscitation, and then calculated the lactate clearance rate(LCR), venous arterial blood carbon dioxide partial pressure(Pcv-aCO2). The patients enrolled in the study according to the 28-days mortality were divided into survival group and death group. We compared two groups of patients with Lac, ScvO2, 6 h LCR and ΔPCO2. The patients according to 6 h LCR and ΔPCO2 after fluid resuscitation were divided into four groups: A group, LCR＜10% and ΔPCO2≥6 mm Hg, B group, LCR≥10% and ΔPCO2≥6 mm Hg; C group LCR＜10% and ΔPCO2＜6 mm Hg; D group, LCR≥10% and ΔPCO2＜6 mm Hg. The length of hospital stay and 28-day mortality were compared between the two groups. Results: Compared with the death group, the 6h LCR of survival group increased significantly and the ΔPCO2 decreased significantly; compared with groups according to 6h LCR and ΔPCO2, the patients of D group had the lowest 28-day mortality, and the patients of A group had the highest 28-day mortality. There was no statistical significance in hospitalization time at ICU between each group. Conclusion: ΔPCO2 and 6 h LCR have good clinical value in predicting the prognosis of patients with sepsis.
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Received: 05 May 2017
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