血管外肺水指数结合血浆大内皮素-1对感染性休克并发ARDS患者预后的预测价值

目的 分析血管外肺水指数(EVLWI)和血浆大内皮素-1(PIE-1)对感染性休克并发急性呼吸窘迫综合征(ARDS)患者预后的预测价值.方法 选取2016年1月—2020年3月重庆市开州区人民医院重症医学科收治的感染性休克并发ARDS患者82例作为研究对象,根据28 d预后结局分为生存组45例,死亡组37例.比较2组E...

The predictive value of extravascular lung water index combined with plasma large endothelin-1 on the prognosis of patients with septic shock complicated by ARDS

Objective To analyze the predictive value of extravascular lung water index(EVLWI)and plasma large endothelin-1(PIE-1)on the prognosis of patients with septic shock complicated by acute respiratory distress syndrome(ARDS).Methods From January 2016 to March 2020,82 patients with septic shock and ARDS who were admitted to the Department of Critical Care Medicine,Kaizhou District People’s Hospital,Chongqing City were selected as the study objects.According to the 28-day prognostic outcome,they were divided into survival group 45 cases and death group 37 cases.Compare the levels of EVLWI and plasma large endothelin-1 in the two groups.Analyze the prognostic value of EVLWI and plasma large endothelin-1 level and the factors affecting the prognosis of patients with septic shock and ARDS.Results The PaO2/FiO2 value of the death group was significantly lower than that of the survival group,and the APACHEⅡscore,SOFA score,EVLWI,and plasma large endothelin-1 levels were significantly higher than those of the survival group(t/P=2.267/0.026,7.142/0.000,3.440/0.001,2.685/0.009,7.493/0.000).The levels of EVLWI and plasma large endothelin-1 in the survival group decreased gradually after admission for 1 to 3 days,while those in the death group increased gradually(F/P=16.799/0.000,9.975/0.000;10.139/0.000,28.616/0.000),at the same time the EVLWI and plasma large endothelin-1 levels in the death group were higher than those in the survival group(EVLWI:t/P=3.771/0.000,10.129/0.000,15.960/0.000;PIE-1:t/P=14.063/0.000,18.194/0.000,23.463/0.000).There was a positive correlation between EVLWI and plasma large endothelin-1 level in the death group(r=0.421,P=0.009).The area under the curve for predicting the death of patients with septic shock complicated by ARDS is 0.898,sensitivity is 81.10%,specificity is 91.10%,and Youden index is 0.722.High APACHEⅡscore,high SOFA score,high EVLWI level,and high plasma large endothelin-1 level are independent risk factors that affect the death of patients with septic shock complicated by ARDS(P<0.05).Conclusion EVLWI and plasma large endothelin-1 levels are independent risk factors for death in patients with septic shock complicated by ARDS,and the combined detection of the two has a higher predictive value for death in patients with this disease.