ĐẶC ĐIỂM HUYẾT ĐỘNG Ở BỆNH NHÂN SỐC NHIỄM KHUẨN VÀ SỐC TIM ĐO BẰNG PHƯƠNG PHÁP HÒA LOÃNG NHIỆT XUYÊN PHỔI

Abstract

Objectives: Studying hemodynamic characteristics in septic shock and cardiogenic shock using transpulmonary thermodiluation. Subjects and methods: ongitudinal prospective study 55 patients divied into 2 groups: septic group with 28 patients and cardiogenic group were treated in Phu Tho General Hospital from February 2019 to December 2021. Results: Male patients higher female ones with cardiogenic group 66,7% and septic shock 57,1%, mean ages in cardiogenic group 65,6±14 and septic group 64,9±12,1. During the first hours of admission, in patients with cardiogenic shock cardiac index in survivors 2,2±0,9 l/ph/m² were signigicantly higher in nonsurvivors 1,7±0,4 l/ph/m²; in patients with septic shock, pulmonary vascular permeability index in survivors 4,5±0,8 were signigicantly higher in nonsurvivors 3,1±0,6. After 24 hours addmitted ICU, in patients with cardiogenic shock cardiac index in survivors 2,7±0,6 l/ph/m² were signigicantly higher in nonsurvivors 1,8±0,3 l/ph/m², systemic vascular resistance index, extravascular lung water index and pulmonary vascular permeability index were lower in nonsurvivors; in patients with septic shock, systemic vascular resistance index, extravascular lung water index and pulmonary vascular permeability index were significantly lower in nonsurvivors. Mortarity in cardiogenic shock 44,4% and septic shock 42,5%. ICU stay in cardiogenic shock 8,6±4,2 and septic shock 8,3±3,9 days. Cardiac index and systemic vascular resistance index were an independent prognostic factor for inpatient of cardiogenic shock and septic shock, respectively. Conclusion: Circulatory shock has a high mortality with 44,4% in cardiogenic group and 42,5% in septic group. After 24 hours addmitted ICU, cardiac index and systemic vascular resistance index are the most important predictor of inpatient mortality.