[Clinical role of evaluating vascular paralysis in septic shock patients].

OBJECTIVE: To explore the effects of vascular paralysis upon prognosis and tissue perfusion in septic shock patients.

METHODS: A total of 73 septic shock patients consecutively admitted into our department from January 2010 to July 2011 were retrospectively studied. Their hemodynamic data, arterial lactate concentration and APACHEII (acute physiology & chronic health evaluation II) score at the beginning of cardiac output monitoring (0h), as well as the outcome of Day 28 post-diagnosis were recorded. Stroke volume index (SVI) and cardiac index (CI) were obtained through transpulmonary thermodilution technique by pulse induced continuous cardiac output (PiCCO) system.

RESULTS: (1) APACHEII score at 0h was higher in non-survivors than those in survivors ((14.6 ± 5.6) vs (20.4 ± 4.8), P < 0.01). Stroke systemic vascular resistance index (SSVRI), pulse pressure/stroke volume index (PP/SVI), effective arterial elastance index (EaI), 24h lactate clearance rate (24rLac) , 72h lactate clearance rate (72rLac) and 7d lactate clearance rate (7rLac) in non-survivors were all lower than those in survivors (P < 0.05); (2) SVRI, SSVRI, PP/SVI and EaI were all correlated significantly with 24rLac, 72rLac and 7rLac [ (212.7 ± 52.6) vs (185.4 ± 50.5) , PP/SVI: (2.8 ± 0.7) vs (2.5 ± 0.6), EaI: (5.0 ± 1.2) vs (4.3 ± 1.1), 24/72/7 rLac: (18.4 ± 46.4) vs (21.5 ± 49.7), (19.9 ± 49.6) vs (-21.5 ± 46.3), (35.5 ± 45.8) vs (-59.5 ± 64.5), P < 0.00].

CONCLUSION: Vascular paralysis is correlated with prognosis and tissue perfusion in septic shock patients. And SSVRI, PP/SVI and EaI are more significant.