关键词: 休克, 脓毒性, 液体复苏, 呼吸力学, 氧代谢, 肺顺应性

Abstract:

Objective To compare the effects between resuscitation regimens of two fluids on respiratory mechanics and oxygen metabolism function in patients with septic shock(SS). Methods Totally 98 patients with SS admitted to our hospital were selected and divided into two groups, limited fluid resuscitation in observation group(n=45), and open fluid resuscitation in control group(n=53). 72 h index of respiratory mechanics, oxygen metabolism, hemodynamics and drug use were counted. Results After treatment, the indexes of the static lung compliance (Cst), oxygen delivery (DO₂), oxygenation index (PaO₂/FiO₂) were higher in observation group than in control group, while blood lactic acid (Lac) was lower (P<0.01). The dose of 24 h resuscitation fluid was lower, but that of vasoactive drugs was higher, and the use time was longer in observation group than in control group (all P<0.05). The correlation analysis showed that the dose of 24 h resuscitation fluid was negatively correlated with Cst,DO₂ and PaO₂/FiO₂ (all P<0.01). The duration of mechanical ventilation and hospitalization were shorter in observation group than in control group(both P<0.01). There was no significant difference in 28-day mortality between two groups (P=0.350). Conclusion In the treatment of SS, limited fluid resuscitation regimen can improve lung compliance and oxygen metabolism without adverse hemodynamic risk.

Key words: shock, septic, fluid resuscitation, respiratory mechanics, oxygen metabolism, lung compliance