UNASSIGNED: This prospective observational study enrolled consecutive patients with sepsis or septic shock over a 6-month period from a tertiary hospital in Marrakech, Morroco. V-CRT and P-CRT were evaluated upon admission, and simultaneous measurements of arterial lactate levels were obtained. The precision of V-CRT and P-CRT in predicting arterial lactate was assessed using ROC curve analysis.
UNASSIGNED: Forty-three patients aged of 64±15 years, of whom 70 % were male, were included in the study. Of these, 23 patients (53 %) had sepsis, and 20 patients (47 %) experienced septic shock. Both V-CRT and P-CRT demonstrated statistically significant correlations with arterial lactate, with correlation coefficients of 0.529 (p < 0.0001) and 0.517 (p = 0.001), respectively. ROC curve analysis revealed that V-CRT exhibited satisfactory accuracy in predicting arterial lactate levels >2 mmol/l, with an area under the curve (AUC) of 0.8 (95 % CI=0.65 - 0.93; p < 0.0001). The prediction ability of P-CRT was lower than V-CRT with an AUC of 0.73 (95 % CI: 0.57-0.89; p = 0.043). The optimal thresholds were determined as 3.4 s for V-CRT (sensitivity = 90 %, specificity = 58 %) and 4.1 s for P-CRT (sensitivity = 85 %, specificity = 62 %).
UNASSIGNED: These findings suggest that the plethysmographic evaluation did not improve the accuracy of CRT for predicting lactate level. However, V-CRT may still serve as a viable surrogate for lactate in septic patients in low-income settings.
这项前瞻性观察性研究纳入了马拉喀什三级医院连续6个月的脓毒症或脓毒性休克患者,Morroco.入院时对V-CRT和P-CRT进行评估,并同时测量动脉乳酸水平。使用ROC曲线分析评估V-CRT和P-CRT预测动脉乳酸的准确性。
■43名年龄为64±15岁的患者,其中70%是男性,包括在研究中。其中,23例患者(53%)有败血症,和20例患者(47%)经历了脓毒性休克。V-CRT和P-CRT均与动脉乳酸具有统计学意义,相关系数为0.529(p<0.0001)和0.517(p=0.001),分别。ROC曲线分析显示,V-CRT在预测动脉乳酸水平>2mmol/l方面表现出令人满意的准确性,曲线下面积(AUC)为0.8(95%CI=0.65-0.93;p<0.0001)。P-CRT的预测能力低于V-CRT,AUC为0.73(95%CI:0.57-0.89;p=0.043)。V-CRT的最佳阈值确定为3.4s(灵敏度=90%,特异性=58%)和P-CRT的4.1s(灵敏度=85%,特异性=62%)。
■这些研究结果表明,体积描记评估并没有提高CRT预测乳酸水平的准确性。然而,在低收入环境中,V-CRT仍可作为脓毒症患者乳酸的可行替代品。