Adopted date: May 18,2023
Objective? To explore the changes of hemodynamic parameters in septic shock patients before and after volume stress test and their predictive value and correlation to the volume response of patients.? Methods? 98 cases of septic shock patients admitted to our hospital were selected for clinical research. According to whether the stroke volume change (△SV) of patients before and after rehydration treatment was ≥15%, they were divided into 53 cases of volume load positive group and 45 cases of volume load negative group. For example, compare the pulse wave continuous cardiac output method (PICCO) and echocardiogram related indexes before and after the volume load test of the two groups of patients, and use receiver operating curve (ROC) to analyze the statistically significant indexes for septic shock The value of the patient"s response to the volume load test is analyzed using a logistics regression model to analyze the relationship between various parameters and the volume load test response. Results? Before the volume load test, the CO, CI, SVV, CVP, HR measured values ??of the volume load positive group and the volume load negative group were compared, and the difference was not statistically significant (P>0.05); after the test, the volume load positive group The CO, CI, and CVP values ??were all higher than the volume load negative group (P<0.05), and the HR and SVV values ??were lower than the volume load negative group (P<0.05); before the volume load test, the volume load positive group and the volume load The comparison of LVOT VTI, LVOT peak flow velocity respiratory variability, and VEpeak measurement values ??of patients in the negative group was not statistically significant (P>0.05); after the test, the LVOT VTI measurement value of the positive volume load group was higher than that of the negative volume load group ( P<0.05), LVOT peak flow velocity respiratory variability is lower than volume load negative group (P<0.05); ROC curve results show CO, CI, SVV, CVP, HR, LVOT peak flow velocity respiratory variability, LVOT VTI index prediction The positive AUC values ??of the volume load reaction were 0.515, 0.560, 0.556, 0.499, 0.898, 0.912, 0.922; Logistic regression model results showed: the higher the APACHEⅡ score, the higher the SOFA score, the lower the CO, the lower the CI, and the lower the CVP The higher the SVV, the lower the LVOT VTI, and the greater the respiratory variability of the LVOT peak flow rate were independent risk factors for the negative volume load test in patients with septic shock (P<0.05).? Conclusion Closely monitoring the relevant hemodynamic parameters of patients with septic shock has important clinical value for predicting the patient"s volume load responsiveness, and is of great significance for guiding patients in clinical fluid resuscitation.