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《Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease》 2012-09
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Feature of extravascular lung water index detected initially in elderly patients with septic shock and its influence on prognosis

JIANG Feng-zhi,HUANG Dao-zheng.Emergency Department,Womens and Childrens Hospital of Foshan,Foshan 528000,China  
Objective To investigate the feature of extravascular lung water index detected initially and its influence on prognosis in patients aged 75 years with septic shock.Methods A retrospective analysis of 29 cases of elderly patients(all 75 years) with septic shock first measured by monitoring PICCO was conducted.According to 28-day-hospital mortality,they were divided into the survival group and death group.Between two groups,age,sex,infection sources,APACHEⅡscores,general hemodynamic parameters(HR,MAP,CVP),lactate concentration and initial EVLWI were analyzed by statistics method,and EVLWI were evaluated as prognostic indicators by depicting ROC curve.Results Between two groups,there were statistically significant difference for APACHEⅡ scores,HR,EVLWI(P=0.044,0.001,0.007),and no significant difference for the other(P0.05).As to EVLWI,ROC curve showed EVLWI≥10.0ml/kg could be as the boundary point,when the sensitivity of predicted deaths was 94.1%,specificity was 66.7%,positive predictive value was 73.8%,negative predictive value was 73.8%,negative predictive value was 45.9%.Conclusion The elderly patients had almost pulmonary edema and had worse tolerance of the lung water than the others,and EVLWI≥10.0ml/kg may serve as a useful index for adverse prognostic outcome.
【CateGory Index】: R459.7
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