title: [The role of central venous pressure to evaluate volume responsiveness in septic shock patients].
abstract: OBJECTIVE
  To investigate the clinical role of central venous pressure (CVP) to evaluate fluid responsiveness in septic shock patients.
  
  
  METHODS
  66 septic shock patients were studied, every patient was administered a volume challenge, before and after it, CVP, intrathoracic blood volume index (ITBVI), global end-diastolic volume index (GEDVI), cardiac index (CI), stroke volume index (SVI) were measured by PiCCO method. All the obtained values were analyzed by statistics method.
  
  
  RESULTS
  Initial CVP in responders is significantly different from that in nonresponders; DeltaITBVI, DeltaGEDVI, DeltaCI, DeltaSVI, DeltaHR (Delta:changes) before and after volume challenge in responders were significantly different from those in nonresponders; the significance of DeltaITBVI, DeltaGEDVI to predict volume responsiveness was strong indicated by high values of areas under the receiver operating characteristic curves (0.674 and 0.700, respectively). If patients were regrouped by CVP <or= 11 mm Hg (1 mm Hg = 0.133 kPa) and CVP > 11 mm Hg, initial ITBVI and GEDVI in responders were not significantly different from that in nonresponders; DeltaITBVI, DeltaGEDVI, DeltaCI, DeltaSVI before and after volume challenge in responders were significantly different from those in nonresponders.
  
  
  CONCLUSIONS
  In septic shock patients, CVP play a guidance role to predict and evaluate volume responsiveness and when CVP was > 11 mm Hg, a positive response will be less likely. Initial volumetric parameters (intrathoracic blood volume and global end-diastolic volume) play a questionable role in predicting and evaluating volume responsiveness, changes before and after volume challenge maybe helpful.
authors.affiliation: Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Xiao-ting
authors.initials: XT
authors.lastname: Wang
authors.forename: Da-wei
authors.initials: DW
authors.lastname: Liu
authors.forename: Wen-zhao
authors.initials: WZ
authors.lastname: Chai
authors.forename: Yun
authors.initials: Y
authors.lastname: Long
authors.forename: Na
authors.initials: N
authors.lastname: Cui
authors.forename: Yan
authors.initials: Y
authors.lastname: Shi
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhou
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D000368:Aged; D001810:Blood Volume; D002302:Cardiac Output; D002496:Central Venous Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012772:Shock, Septic / Q000503:physiopathology*