Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3008
Peer-review started: February 18, 2021
First decision: March 7, 2021
Revised: March 9, 2021
Accepted: March 12, 2021
Article in press: March 12, 2021
Published online: May 6, 2021
Processing time: 63 Days and 1.6 Hours
Sepsis usually causes hemodynamic abnormalities. Hemodynamic index is one of the factors to identify the severity of sepsis and an important parameter to guide the procedure of fluid resuscitation. The present study investigated whether the assessment of hemodynamic indices can predict the outcomes of septic patients undergoing resuscitation therapy.
To evaluate the prognostic value of hemodynamic indices in patients with sepsis after fluid resuscitation.
A retrospective study was conducted in 120 patients with sepsis at Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University between October 2016 and October 2019. All patients were treated with sodium chloride combined with dextran glucose injection for fluid resuscitation. Patients’ hemodynamic parameters were monitored, including heart rate (HR), cardiac index (CI), systemic vascular resistance index (SVRI), mean arterial pressure (MAP), central venous pressure (CVP), and central venous oxygen saturation. The prognostic value of hemodynamic indices was determined based on the prognosis status.
During fluid resuscitation, 86 patients developed septic shock and 34 did not. Ninety-nine patients survived and 21 patients died at 28 d after the treatment. Heart rate, CI, mean arterial pressure, SVRI, and CVP were higher in patients with septic shock and patients who died from septic shock than in non-shock patients and patients who survived, and central venous oxygen saturation was lower in patients with shock and patients who died than in non-shock patients and the survivors (P < 0.05). When prognosis was considered as a dependent variable and hemodynamic parameters was considered as independent variables, the results of a logistic regression analysis showed that CI, SVRI, and CVP were independent risk factors for septic shock, and CI was an independent risk factor for 28-d mortality (P < 0.05).
Hemodynamic indices can be used to evaluate the prognosis of septic patients after fluid resuscitation.
Core Tip: Sepsis is usually associated with hemodynamic changes. Hemodynamic monitoring is commonly used to guide resuscitation therapy. This study explored the role of hemodynamic indices for the prediction of outcomes in patients with sepsis undergoing fluid resuscitation. The findings suggested that cardiac index, systemic vascular resistance index, and central venous pressure were independent risk factors for the occurrence of septic shock, and cardiac index was an independent risk factor for the occurrence of death at 28 d after the treatment.