Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2021; 9(13): 3008-3013
Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3008
Prognostic value of hemodynamic indices in patients with sepsis after fluid resuscitation
He-Ping Xu, Xiao-An Zhuo, Jin-Jian Yao, Duo-Yi Wu, Xiang Wang, Ping He, Yan-Hong Ouyang
He-Ping Xu, Xiao-An Zhuo, Jin-Jian Yao, Duo-Yi Wu, Xiang Wang, Ping He, Yan-Hong Ouyang, Department of Emergency Medicine, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
Author contributions: Xu HP and Zhuo XA contributed equally to this manuscript, and considered as co-first authors; Xu HP, Zhuo XA, Yao JJ, Wu DY, Wang X, He P, and Ouyang YH collected and analyzed data and wrote the manuscript; all the authors approved the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Hainan General Hospital Institutional Review Board.
Informed consent statement: All study participants provided informed written consent.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Hong Ouyang, MD, Chief Physician, Department of Emergency Medicine, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, No. 31 Xiuhua Road, Xiuying District, Haikou 570311, Hainan Province, China. ouyang1893@126.com
Received: February 18, 2021
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
ARTICLE HIGHLIGHTS
Research background

Sepsis is always associated with high mortality. Early diagnosis and appropriate treatment help to improve outcomes. Like markers such as body temperature, leukocyte count, C-reactive protein, and procalcitonin as well as tumor necrosis factor-alpha, interleukin (IL)-6, IL-8, IL-10, and HLA-DR expression, hemodynamic indices guide clinicians to make a reasonable decision. However, no specific markers for sepsis have been identified.

Research motivation

Hemodynamic monitoring is essential to the care of septic patients. By assessing the hemodynamic indices, patient condition is determined so that timely subsequent interventions will be given accordingly. Whether its role is as important as the above-mentioned markers or factors in the management of sepsis? The present study reported the performance of hemodynamic indices for predicting the outcomes including risk of shock and mortality in septic patients.

Research objectives

To discuss the potential predictive and prognostic value of hemodynamic indices for relevant clinical outcomes in patients with sepsis.

Research methods

Hemodynamic indices were monitored in patients with sepsis, including heart rate (HR), cardiac index (CI), mean arterial pressure (MAP), systemic vascular resistance index (SVRI), central venous pressure (CVP), and central venous oxygen saturation (ScvO2). The differences in hemodynamic indices were compared between patients with shock and patients without shock and between non-survivors and survivors.

Research results

The results revealed that HR, CI, MAP, SVRI, and CVP were higher in septic shock patients and non-survivors than in non-shock patients and survivors. However, ScvO2 was lower in septic shock patients and non-survivors than in non-shock patients and survivors.

Research conclusions

Patients with high HR, CI, MAP, SVRI, and CVP levels and low ScvO2 level probably develop severe disease or experience worsening disease. Hemodynamic indices may have predictive value for the outcomes and prognosis in patients with sepsis.

Research perspectives

Recently, studies showed that static measures were replaced by dynamic measures for the prediction of fluid responsiveness and cardiac performance. In view of this, studies in the future should take the dynamic markers into consideration.