Significance of Early Postoperative Arterial Lactic Acid, Inferior Vena Cava Variability, and Central Venous Pressure in Hypovolemic Shock

• Main Authors: Wei Lin, Xingsheng Lin, Yingfeng Zhuang, Xiaobin Pan, Chao Wu, Shujuan Zhang, Lihui Zhang, Jian Lin, Songjing Shi, Songchang Shi
• Format: Article
• Language: English
• Published: Hindawi Limited 2019-01-01
• Series: Emergency Medicine International
• Online Access: http://dx.doi.org/10.1155/2019/6504916

Introduction. Up to one-third of patients admitted to the ICU are in circulatory shock, and early recognition of the condition is vital if subsequent tissue injuries are to be avoided. We would like to know what role the arterial lactic acid, inferior vena cava variability, and CVP (central venous pressure) play in the early stages of shock. Methods. This is a retrospective study of patients who underwent surgical resuscitation in the Department of Critical Care Medicine. We use the ROC (receiver-operating characteristic) curve to evaluate the significance of each indicator in the diagnosis. For correlation analysis between groups, we first use linear regression for processing and then analysis with correlation. Results. The ROC curve analysis shows that the area under the curve of the lactic acid group was 0.9272, the area under the curve of the inferior vena cava variability group was 0.8652, and the area under the curve of the CVP group was 0.633. Correlation analysis shows that the inferior vena cava variability and arterial lactic acid Pearson’s r = 0.2863 and CVP and arterial lactic acid Pearson’s r = 0.0729. Conclusion. The diagnostic value of arterial lactate is still very high and can still be used as an early warning indicator to help clinicians be alert to the microcirculatory disorders that have emerged quietly. The degree of inferior vena cava variability is linearly related to arterial lactic acid and can also be used as a reference indicator for early evaluation of shock. The diagnostic value of CVP is obviously lower.