• Shock · Jun 2024

    Central venous-to-arterial carbon dioxide partial pressure difference as a guiding parameter for cardiotonic drug administration in patients with early-stage septic shock.

    • Ya-Qian Qu, Xiao-Hui Shen, Qian Zhao, Hui Guo, Xu-Rui Li, Jian-Guo Li, Hui-Ling Zang, and Jing Qin.
    • Department of Intensive Care Unit, Shijiazhuang People's Hospital, Shijiazhuang, China.
    • Shock. 2024 Jun 1; 61 (6): 836840836-840.

    AbstractObjective: This study aimed to investigate the effect of the central venous-to-arterial carbon dioxide partial pressure difference (Pcv-aCO2) on the administration of cardiotonic drugs in patients with early-stage septic shock. Methods: A retrospective study was conducted on 120 patients suffering from septic shock. At admission, the left ventricular ejection fraction (LVEF) and Pcv-aCO2 of the patients were obtained. On the premise of mean arterial pressure ≥ 65 mm Hg, the patients were divided into two groups according to the treatment approaches adopted by different doctors-control group: LVEF ≤50% and observation group: Pcv-aCO2 ≥ 6. Both groups received cardiotonic therapy. Results: The two groups of patients had similar general conditions and preresuscitation conditions ( P > 0.05). Compared with the control group, the observation group had a higher mean arterial pressure, lactic acid clearance rate, and urine output after 6 h of resuscitation ( P < 0.05), but a lower absolute value of lactic acid, total fluid intake in 24 h, and a lower number of patients receiving renal replacement therapy during hospitalization ( P < 0.05). After 6 hours of resuscitation, the percentages of patients meeting central venous oxygen saturation and central venous pressure targets were not significantly different between the control and observation groups ( P > 0.05). There was no difference in the 28-day mortality rate between the two groups ( P > 0.05). Conclusion: Pcv-aCO2 is more effective than LVEF in guiding the administration of cardiotonic drugs in the treatment of patients with septic shock.Copyright © 2024 by the Shock Society.

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