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Volume 14 Issue 6
Nov.  2023
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ZHOU Gaosheng, WANG Xiaoting, LIU Jingjing, ZHANG Hongmin, ZHANG Qing, LIU Dawei. Relationship between Oxygen Extraction Ratio and Prognosis in Septic Shock Patients During Early Resuscitation[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(6): 1217-1223. DOI: 10.12290/xhyxzz.2023-0008
Citation: ZHOU Gaosheng, WANG Xiaoting, LIU Jingjing, ZHANG Hongmin, ZHANG Qing, LIU Dawei. Relationship between Oxygen Extraction Ratio and Prognosis in Septic Shock Patients During Early Resuscitation[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(6): 1217-1223. DOI: 10.12290/xhyxzz.2023-0008
shu

Relationship between Oxygen Extraction Ratio and Prognosis in Septic Shock Patients During Early Resuscitation

  • 1.

    Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Department of Critical Care Medicine, The First College of Clinical Medicine Science, Three Gorges University, Yichang Central People's Hospital, Yichang, Hubei 443003, China

Funds: 

Capital Clinic Research and Demonstration Application of Diagnosis and Treatment Project Z201100005520038

Beijing Natural Science Foundation Project 7232126

More Information
  • Corresponding author:

    LIU Dawei, E-mail: dwliu2015@sina.com

  • Received Date: January 03, 2023
  • Accepted Date: July 31, 2023
  • Issue Publish Date: November 29, 2023
    Graphical Abstract
    • Abstract
  •   Objective  To investigate the relationship between Oxygen extraction ratio(ERO2) and prognosis of septic shock patients in the early stage of resuscitation.
      Methods  The data of the patients with septic shock admitted to the department of Critical Care Medicine of Peking Union Medical College Hospital from January 2016 to July 2021 were retrospectively collected. The patients were divided into the survival group and the death group according to the prognosis of the ICU. The baseline data, and Oxygen metabolism indexes including Oxygen delivery (DO2), Oxygen consumption(VO2), ERO2 and lactate(Lac) of the two groups were collected. Risk factors for ICU death in patients with septic shock were analyzed using multifactorial Logistic regression, and the predictive value of each indicator for ICU death in patients with septic shock was assessed using receiver operating characteristic (ROC) curves.
      Results  A total of 73 patients with septic shock who met the inclusion and exclusion criteria were enrolled, including 21 cases in the death group and 52 cases in the survival group. The differences in acute physiology and chronic health evaluationⅡ(APACHEⅡ) scores and sequential organ failure assessment (SOFA) scores between the two groups were statistically significant (all P < 0.05). Compared with the survival group, 6 h after resuscitation in the death group, Lac [5.6(4.2, 10.0)mmol/L vs. 3.4(2.1, 6.9)mmol/L, P=0.009], VO2[(165±95) mL/(min·m2) vs. (106±58)mL/(min·m2), P=0.012], ERO2[(56.56±19.48)% vs.(33.71±13.24)%, P=0.000] were elevated, and there was no significant difference in DO2 between the two groups[266 (214, 384) mL/(min·m2) vs. 300 (250, 396)mL/(min·m2), P=0.159]. The results of multifactorial Logistic regression analysis showed that ERO2 was an independent risk factor for ICU death in patients with septic shock (OR=1.126, 95% CI: 1.053-1.203, P=0.000). The ROC curve showed that the area under the curve (AUC) of ERO2 for predicting ICU death in septic shock patients was 0.833, with an optimal threshold of 45.93%, sensitivity of 76.19%, specificity of 94.23%, and its predictive efficacy was superior to that of the APACHEⅡ scores(AUC: 0.704), SOFA score(AUC: 0.778), and Lac(AUC: 0.668).
      Conclusion  ERO2 in the early stage of septic shock resuscitation is an independent risk factor for ICU prognosis, which has a good predictive value for the prognosis of septic shock.
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