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脓毒性休克患儿血液氧代谢指标变化及其临床意义
Changes in blood oxygen metabolism indices and their clinical signifcance in children with septic shock
脓毒性休克治疗的关键是提供充足的氧供和改善组织灌注，目前常用的反映氧代谢的指标是乳酸 （Lac）和中心静脉血氧饱和度 （ScvO2），但是当乳酸和ScvO2处于正常范围时，组织仍然可能存在缺氧。静动脉二氧化碳分压差 （CO2 gap）在ScvO2正常时可以准确反映机体氧供情况。本文就乳酸和乳酸清除率、ScvO2和CO2 gap在判断组织缺氧时的优点和不足进行综述，以期为脓毒性休克的治疗和病情判断提供依据。
The key to the treatment of septic shock is to provide adequate oxygen supply and improve tissue perfusion. Lactate and central venous oxygen saturation (ScvO2) are commonly used as the indices of oxygen metabolism, but tissue hypoxia may still exist even when lactate and ScvO2 are within the normal range. Arteriovenous difference in carbon dioxide partial pressure (CO2 gap) can accurately reflect oxygen delivery when ScvO2 is in the normal range. This article reviews the advantages and shortages of lactate, lactate clearance rate, ScvO2, and CO2 gap in evaluating tissue hypoxia, in order to provide a reference for treatment and severity evaluation of septic shock.
静动脉二氧化碳分压差 / 中心静脉血氧饱和度 / 氧代谢指标 / 脓毒性休克 / 儿童
Arteriovenous difference in carbon dioxide partial pressure / Central venous oxygen saturation / Oxygen metabolism index / Septic shock / Child
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