Effects of early goal-directed therapy on systematic oxygen metabolism and gastric mucosal pH in the patients with septic shock.

Objective To evaluate the effects of early goal-directed therapy(EGDT)on systematic oxygen metabolism and gastric mucosal pH in patients with septic shock.Methods We modulated central venous pressure(CVP)to 8～12mmHg(CVP 12～15 mmHg with ventilation),mean arterial pressure(MAP)to 6～90 mmHg,mixed venous blood oxygen saturation(SmvO2)to more than 70% and urine output(UO)more than 0.5 ml·kg-1·h-1 with EGDT in 40 patients with septic shock and then monitored systemic oxygen metabolism and Phi throughout resuscitation.Results Indexes of systematic oxygen metabolism showed a higher DO2(P 0.05)and a lower ERO2(P 0.05)in comparison with control,but no significant differences were found for VO2(P 0.05);Before and after the target was reached,VO2 and DO2 had significant positive relations respectively(r =0.36,0.35;P 0.05).As for indexes of regional perfusion,Phi increased higher than the baseline after getting to the target with the progression of treatment(P 0.05).According to the 28 d mortality,the Phi of survival group got obviously higher than that of the death group(P 0.05).Conclusion EGDT could increase DO2 in patients suffering from septic shock.EGDT can also increase Phi and improve gastrointestinal blood perfusion.To monitor Phi may have more important clinic value in judging expectation,guiding treatment and decreasing mortality.