Comparative study of circulating oxygen metabolism indicators monitoring and ultrasound indicators monitoring in volume management of patients with septic shock
LI Youfu
ZHUANG Shuilong
Abstract：Objective:To explore the application value and correlation of circulating oxygen metabolism indicators[(central venous oxygen saturation(ScvO2),venous-to-arterial carbon dioxide partial pressure difference(P(v-a)CO2)]and ultrasound indicators(inferior vena cava width and variability,cardiac function parameters,and lung B-line)in volume management of patients with septic shock,so as to optimize fluid resuscitation strategies.Methods:A total of 180 patients with septic shock(blood lactate>4 mmol/L)admitted to Yiyang Central Hospital from January 2023 to March 2025 were selected and divided into 4 groups(A-D groups)based on oxygen metabolism indicators(ScvO2,P(v-a)CO2)and 6 groups(E-J groups)based on ultrasound indicators(inferior vena cava width and variability).All patients received fluid resuscitation treatment,with oxygen metabolism reaching the standard(ScvO2>70％,P(v-a)CO2<6 mmHg)and ultrasound reaching the standard(inferior vena cava width>20 mm,variability<50％)as endpoints.Changes in indicators(before and 24 h after resuscitation)were recorded,and the total amount of infusion,incidence of pulmonary edema,and correlation between indicators were compared.Results:After resuscitation,inferior vena cava variability in Group A(ScvO2<70％,P(v-a)CO2>6 mmHg)significantly decreased(P<0.05),while the cardiac index(CI)and cardiac output(CO)significantly increased(P<0.05).Group D(ScvO2>70％,P(v-a)CO2<6 mmHg)had the lowest incidence of pulmonary edema(8.33％).After resuscitation,ScvO2 significantly increased(P<0.05)and P(v-a)CO2 significantly decreased(P<0.05)in group E(inferior vena cava width<10 mm,variability>50％).Group J(inferior vena cava width>20 mm,variability<50％)had the highest oxygen metabolism compliance rate(91.67％).Patients who referred to both oxygen metabolism and ultrasound indicators had a lower total volume of infusion(P<0.05)and a significantly lower incidence of pulmonary edema compared to the single indicator group(P<0.05).After 6-12 h of resuscitation,the consistency between oxygen metabolism and ultrasound indicators reached 78.33％,and was negatively correlated with Sequential Organ Failure Assessment(SOFA)(r=-0.421,P<0.01).Conclusion:Circulating oxygen metabolism indicators and ultrasound indicators complement each other in volume management of septic shock.Combined monitoring can optimize fluid resuscitation strategies,reduce the risk of excessive fluid replacement,and improve patient prognosis.
Keywords：septic shockvolume managementcirculating oxygen metabolismultrasound indicatorsfluid resuscitation
Publication Date：2025-08-28
Online Publishing Date：2025-09-26(First online date of this platform, not the publication date of the document)
Pages：4( 5-8 )