Detection and Prognosis of Extravascular Lung Water Index in Elderly Patients with Respiratory Failure and Septic Shock
XIANG Shu-lin;Intensive Care Unit,the People's Hospital of Guangxi Zhuang Autonomous Region;
Objective To investigate the characteristics and prognostic value of extravascular lung water index( EVLWI) for the death in elderly patients with respiratory failure and septic shock. Methods Thirty-six elderly patients with respiratory failure and septic shock were divided into survival group( 21 patients) and death group( 15patients) according to clinical outcome. All the patients were monitored with pulse indicator continuous cardiac output( PICCO) monitor,and their EVLWI,general ejection fraction( GEF),system vascular resistance index( SVRI),central venous pressure( CVP),cardiac index( CI),heart rate( HR) and mean arterial pressure( MAP) were collected; The APACHEⅡscore and blood lactate( Lac) and were also recorded. Results APACHEⅡ score,Lac,EVLWI in the death group were significantly higher than those in the survival group( P 0. 05),CI,GEF,SVRI,CVP,HR and MAP showed no significant difference between two groups( all P 0. 05). The ROC curve of EVLWI indicated that EVLWI≥10 ml / kg could be the value of prognosis for death,and the sensitivity,specificity,positive predictive value,negative predictive value were 66. 67%,90. 48%,83. 33%,79. 17% respectively. Conclusion The mortality of elderly patients with respiratory failure and septic shock increases while EVLWI is significantly higher,EVLWI≥10 ml / kg can be the value of prognosis for death.