J Crit Care:中心静脉压对重症患者预后的影响

2017-07-04 MedSci MedSci原创

本研究旨在探讨中心静脉压对危重病患者脏器功能及预后的影响。

本研究旨在探讨中心静脉压对危重病患者脏器功能及预后的影响。

我们对单一医学中心ICU收住的488名患者进行为期半年的回顾性队列研究,研究对象为中心静脉压及其他临床参数,分别从ICU住院时间、危重病患者评分(SOFA和APACHE II)、血清肌酐和乳酸水平进行评估。

治疗初期,CVP峰值和平均CVP水平与危重患者的ICU住院时间、乳酸峰值水平和SOFA评分显著相关,CVP峰值和肌酐水平显著相关,初始平均CVP水平和肌酐值无明显相关性。亚组分析显示,对于CVP峰值大于12mmHg以上患者来说,住院时间明显延长、器官功能显著恶化、SOFA评分明显高于对照组。ROC曲线分析表明,CVP峰值大于11.5mmHg的重症患者死亡率有明显升高趋势。

最终我们得出结论:重症患者中心静脉压越高,临床预后和器官功能越差。因此,在对危重症患者进行治疗中,尽量避免患者的中心静脉压过高。

原始出处:

Wang X1, Chen H1, et al. The correlation between CVP-derived parameters and the prognosis of critically ill patients. J Crit Care. 2017 Mar 16;40:257-264. doi: 10.1016/j.jcrc.2017.03.011.

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    2018-03-28 fusion
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    2017-07-13 慧读

    谢谢各位,学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1715613, encodeId=96f01e15613df, content=<a href='/topic/show?id=83622218699' target=_blank style='color:#2F92EE;'>#中心静脉压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22186, encryptionId=83622218699, topicName=中心静脉压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9e5631964592, createdName=ms4657536712156177, createdTime=Mon Feb 19 17:34:00 CST 2018, time=2018-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691911, encodeId=316c169191115, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Mon May 14 21:34:00 CST 2018, time=2018-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1796978, encodeId=7ab41e96978ad, content=<a href='/topic/show?id=5a6e221853a' target=_blank style='color:#2F92EE;'>#中心静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22185, encryptionId=5a6e221853a, topicName=中心静脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Mon Jun 04 06:34:00 CST 2018, time=2018-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697493, encodeId=1b98169e493a5, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Wed Mar 28 22:34:00 CST 2018, time=2018-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=221851, encodeId=effe2218511b, content=谢谢各位,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7f401615413, createdName=慧读, createdTime=Thu Jul 13 12:03:21 CST 2017, time=2017-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284007, encodeId=4c6c128400e10, content=<a href='/topic/show?id=cdb79594643' target=_blank style='color:#2F92EE;'>#重症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95946, encryptionId=cdb79594643, topicName=重症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c3a189, createdName=longqijun248, createdTime=Thu Jul 06 02:34:00 CST 2017, time=2017-07-06, status=1, ipAttribution=)]