Clinical Study On The Relationship Between Transcutaneous Blood Gas Monitoring Indexes And Septic Shock And Its Predictive Value

Objectives The patients with septic shock?Septic Shock?in intensive care unit?ICU?were selected,and the percutaneous blood gas monitoring indexes measured through the medial forearm of upper limb at different time points?within 2 hours of diagnosis and 24hours of diagnosis?were measured.The relationship between the above indexes and septic shock was analyzed statistically,and the predictive value of these indexes for septic shock was evaluated.Methods Twenty-six patients with septic shock diagnosed in our hospital from October2017 to March 2018 were selected.The general data of the patients,including name,sex,age,hospitalization number and so on,were recorded at the time of admission,and the site of infection and APACHE?score were recorded.Arterial partial pressure of oxygen?PaO₂?,arterial partial pressure of carbon dioxide?PaO₂?,percutaneous tissue partial pressure of oxygen?PtcO₂?,partial pressure of carbon dioxide?PtcCO₂?and arterial blood gas lactic acid?Lac?,were monitored and diagnosed within 2 h and 24 h.The oxygen migration degree,carbon dioxide migration degree and other indexes are calculated.Fourteen patients who were about to be discharged from hospital were selected as the control group.the relationship between the above collected indexes and septic shock was analyzed statistically,and the predictive value of these indexes for septic shock was evaluated.Results 1 Overall data of patients:among the 40 patients included in the study,there were 26 patients in the case group,including 13 males and 13 females,aged from 40 to 72years,with an average of?62.73±7.37?years.There were 14 patients in the control group,including 6 males and 8 females.The age ranged from 42 to 74 years,with an average of?63.43±9.86?years.There was no significant difference in sex ratio and age data between the two groups?P>0.05?.There were 10 cases of pulmonary infection,8 cases of abdominal infection,4 cases of urinary tract infection and 4 cases of hematogenous infection in the case group.2 Compared with the control group,there were significant differences in arterial blood gas lactic acid,PtcO₂ and percutaneous carbon dioxide migration between the septic shock group and the control group at 2 h after diagnosis?P<0.05?.At 24 h,there was significant difference in arterial blood gas lactic acid between septic shock group and control group?P<0.05?,but there was no significant difference in other indexes?P>0.05?.The results of relationship analysis showed that PtcO2 and percutaneous carbon dioxide migration were related to the occurrence of septic shock.3The truncated values of PtcO₂ and percutaneous carbon dioxide offset were 55.500mmHg and 0.066%respectively by ROC curve analysis,and the diagnostic effects of PtcO2 and percutaneous carbon dioxide offset were both possible?AUC>0.7?.4 The joint prediction factors of PtcO₂ and percutaneous carbon dioxide migration were obtained by Logistic regression,and the joint prediction factors,PtcO₂ and percutaneous carbon dioxide migration were analyzed by ROC curve.The results showed that the area under the curve of PtcO₂ and percutaneous carbon dioxide migration were 0.727 and 0.709 respectively,while the combined prediction factor of the four indexes was 0.816,and the sensitivity and specificity of the combined prediction factor were 80.8%and 71.4%,respectively.5 The results of 2h PtcO₂ and percutaneous carbon dioxide migration in the diagnosis of septic shock were consistent with those of combined predictors?P<0.05?.Conclusions Transcutaneous partial pressure of oxygen and transcutaneous carbon dioxide offset have certain significance in the diagnosis of septic shock.percutaneous blood gas monitoring can be used as a monitoring tool for early diagnosis of septic shock.Figure 1;Table 9;Reference 108...