Central Venous Pressure Dropped Early is Associated with Organ Function and Prognosis in Septic Shock Patients: A Retrospective Observational Study

Xiao-Ting Wang, Bo Yao, Da-Wei Liu, Hong-Min Zhang
Shock 2015, 44 (5): 426-30

PURPOSE: The aim of this study was to investigate changes in central venous pressure (CVP) of patients with septic shock over 7 days after intensive care unit admission and its effect on organ function and clinical prognosis.

METHODS: Baseline data, 7 days' CVP, and laboratory data of 105 patients with septic shock were consecutively recorded. According to the value of mean CVP of 7 days, cases were divided into three groups: low (<8 mmHg), normal (8-12 mmHg), and high (>12 mmHg) CVP. According to whether CVP dropped to less than 8 mmHg, cases were divided into two groups.

RESULTS: There were significant differences in serum creatinine on day 5 and lactate on days 2 to 5 among low, normal, and high-CVP groups (P < 0.05). Total bilirubin on days 5 to 7, lactate on days 2 and 4 to 7, and SOFA (Sepsis-related Organ Failure Assessment) scores on days 5 and 7 in groups with CVP did not drop to less than 8 mmHg were higher than those in groups with CVP that dropped to less than 8 mmHg (P < 0.05). PO2/FIO2 on day 7 was lower in the group whose CVP did not drop to less than 8 mmHg (226 [184-278]) vs. 254 [214-306]; P = 0.048), whereas 28-day mortality was lower in the group whose CVP dropped to less than 8 mmHg (18.3% vs. 37.8%, P = 0.026).

CONCLUSIONS: Central venous pressure was associated with kidney, liver, and lung function; SOFA scores; and lactate. Septic shock patients whose CVP dropped to less than 8 mmHg during 7 days had a higher survival rate.

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