[The role of central venous pressure to evaluate volume responsiveness in septic shock patients].
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.
Wang
Xiao-ting
XT
Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Liu
Da-wei
DW
Chai
Wen-zhao
WZ
Long
Yun
Y
Cui
Na
N
Shi
Yan
Y
Zhou
Xiang
X
Zhang
Qing
Q
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*