Correlation Of RSO₂ And Pcv-aCO₂,Lac,APACHEⅡ Score And Sofa Score In Sepsis Patients

Objective:Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.Septic shock is defined as a subset of sepsis in which underlying circulatory and cellular metabolism abnormalitiesareprofoundenoughtosubstantiallyincrease mortality.Early diagnosis of sepsis,judging the severity of the disease by various indexes and selecting treatment methods in a timely and reasonable manner are the most effective means to control the disease,reduce the complications of multiple organs and reduce the mortality rate.In this study,cerebral regional oxygen saturation,arteriovenous carbon dioxide partial pressure and lactic acid were measured in septic patients.Combined Acute Physiology and chronic Health scoring system Ⅱ and Sequential organ failure score,We will investigate the correlation between cerebral oxygen saturation and Pcv-aCO₂,Lac,APACHEⅡ score in intensive care unit（ICU）for patients with sepsis.Methods:We defined 20 patients,who was admitted to the Department of Intensive Care of Hunan Cancer Hospital from Sep.2017 to Apr.2018 and was diagnosed with sepsis in the new standard of SEPSIS 3.0^[1],as a sepsis group.On the contrary,20 patients with non-sepsis diagnosed at the same time were included in the non-sepsis group.Collect general information of patients after hospital admission,conduct continuous monitoring of rSO₂ for 48 hours,and collect patients T1=0h during the course of treatment（the first time after sepsis patients were diagnosed with sepsis and start treatment and non-sepsis patients The first time the treatment started）,T2=6h（6h after standard treatment in both groups）,T3=24h（24h after standard treatment in both groups）,T4=48h（standardized treatment in both groups after 48 hours）,blood samples were taken at this 4 time points to check blood routine,blood gas analysis,liver and kidney function,electrolytes,and coagulation function.The data of rSO₂,Pcv-aCO₂,Lac,APACHEⅡ scores,and SOFA scores at these four time points were recorded.According to the case inclusion criteria,they were divided into sepsis group（study group）and non-sepsis group（control group）.According to the outcome of the discharge,sepsis patients were divided into survival group and death group（after treatment or heavier condition,they were automatically treated and discharged as the death group）.According to the treatment,the lactic acid condition was divided into normal lactic acid group and abnormal lactic acid group.SPSS20.0 software was used for statistical analysis of the data.The data of normal distribution were expressed as（mean （?）±s standard deviation）.The two groups were compared using independent sample t test.The chi-square test was used for different count data.The inter-variable correlation was analyzed by rank correlation to analyze the correlation between rSO₂ and Pcv-a CO₂,Lac,APACHEⅡ scores,and SOFA scores in sepsis patients.P<0.05 indicates that the data is statistically significant.Results:1.Sepsis group compared with the general non-sepsis group,there was no significant difference in age,weight,height,heart rate,mean arterial pressure,platelets,high blood pressure,diabetes,coronary heart disease,smoking history,chronic obstructive pulmonary disease,the number of days in ICU hospitalization,number of mechanical ventilation,GCS scores,number of vasoactive drugs,number of antibiotics,bilirubin,and creatinine（P>0.05）.There were significantly different（P<0.05）in gender,respiratory rate,white blood cell,rSO₂,Pcv-aCO₂,Lac,APACHEⅡ,SOFA,and rSO₂ at non-sepsis.The rSO₂ was higher in the non-sepsis than in the sepsis group.Pcv-aCO₂,Lac,APACHEⅡ score,SOFA score were lower than the sepsis group.2.In the sepsis group,rSO₂ was lower than the non-sepsis group at four time points during the 48 h treatment;the Pcv-aCO₂,Lac,APACHEⅡ scores,and SOFA scores were all higher than those of the non-sepsis group,and P<0.05,with statistical significance.3.In the sepsis group,rSO₂ increased at 4 time points during the 48 hours of treatment,P<0.05,with statistical significance;Pcv-aCO₂,Lac,APACHEⅡ score,SOFA score showed a downward trend,P<0.05,with statistics Significance;There was a negative correlation between rSO₂and Pcv-aCO₂,Lac,APACHEⅡ scores,and SOFA scores,and P<0.05,with statistical significance.4.The rSO₂ in the death group was lower than that in the survival group;the Pcv-aCO₂,Lac,APACHEⅡ scores,and SOFA scores were all higher than those in the survival group（P<0.05）.The difference was statistically significant.5.RSO₂ in the normal lactate group was higher than that in the lactic acid abnormal group;Pcv-aCO₂,Lac,APACHEⅡ scores,and SOFA scores were all lower than those in the lactic acid abnormal group（P<0.05）.The difference was statistically significant.6.When combined with rSO₂+Lac+Pcv-aCO₂ in sepsis fluid resuscitation,the area under the ROC curve for the combination of rSO₂+Lac+Pcv-aCO₂ to direct liquid resuscitation was 0.881.The area under the ROC curve of rSO₂ was higher than that of Lac,Pcv-aCO₂,APACHEⅡ,and SOFA scores,which was 0.679.Conclusion:1.There was a negative correlation between rSO₂ and Pcv-aCO₂,Lac,APACHEⅡ scores,and SOFA scores in the treatment of sepsis patients for 48 hours.2.The use of rSO₂ in combination with Lac and Pcv-aCO₂ is more valuable for judging fluid recovery in patients with sepsis.