Central Venous Pressure Dropped Early is Associated with Organ Function and Prognosis in Septic Shock Patients: A Retrospective Observational Study

Shock. 2015 Nov;44(5):426-30. doi: 10.1097/SHK.0000000000000445.

Abstract

Purpose: The aim of this study was to investigate changes in central venous pressure (CVP) of patients with septic shock over 7 days after intensive care unit admission and its effect on organ function and clinical prognosis.

Methods: Baseline data, 7 days' CVP, and laboratory data of 105 patients with septic shock were consecutively recorded. According to the value of mean CVP of 7 days, cases were divided into three groups: low (<8 mmHg), normal (8-12 mmHg), and high (>12 mmHg) CVP. According to whether CVP dropped to less than 8 mmHg, cases were divided into two groups.

Results: There were significant differences in serum creatinine on day 5 and lactate on days 2 to 5 among low, normal, and high-CVP groups (P < 0.05). Total bilirubin on days 5 to 7, lactate on days 2 and 4 to 7, and SOFA (Sepsis-related Organ Failure Assessment) scores on days 5 and 7 in groups with CVP did not drop to less than 8 mmHg were higher than those in groups with CVP that dropped to less than 8 mmHg (P < 0.05). PO2/FIO2 on day 7 was lower in the group whose CVP did not drop to less than 8 mmHg (226 [184-278]) vs. 254 [214-306]; P = 0.048), whereas 28-day mortality was lower in the group whose CVP dropped to less than 8 mmHg (18.3% vs. 37.8%, P = 0.026).

Conclusions: Central venous pressure was associated with kidney, liver, and lung function; SOFA scores; and lactate. Septic shock patients whose CVP dropped to less than 8 mmHg during 7 days had a higher survival rate.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Bilirubin / blood
  • Biomarkers / blood
  • Central Venous Pressure / physiology*
  • Creatinine / blood
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lactic Acid / blood
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Shock, Septic / diagnosis
  • Shock, Septic / physiopathology*

Substances

  • Biomarkers
  • Lactic Acid
  • Creatinine
  • Bilirubin