The value of the proportion of perfused vessels change rate in the evaluation of early organ function deterioration in septic shock and ARDS

Abstract

This study explores the relationship between the proportion of perfused vessels change rate (ΔPPV), the shedding of the glycocalyx marker syndecan-1 (SDC-1), and the utility of ΔPPV in assessing early organ function deterioration in septic shock and acute respiratory distress syndrome (ARDS) patients.Patients were categorized into two groups based on the change in their Sequential Organ Failure Assessment (SOFA) score over 24 hours: the organ function deterioration group (SOFA_24h-0h score ≥ 1) and the non-deterioration group (SOFA_24h-0h score < 1). Sublingual microcirculation, lactic acid levels, and SDC-1 were evaluated at 0 and 6 hours. The primary endpoint was the area under the curve (AUC) for ΔPPV and its combination with lactate clearance rate (LCR). Secondary endpoints included the correlation between ΔPPV and SDC-1, hospital mortality, and survival analysis.The study included 67 patients. The AUC for ΔPPV was 0.813 (95% CI: 0.707-0.919), and when combined with LCR, it was 0.871 (95% CI: 0.785- 0.957). Additionally, a negative correlation between ΔPPV and SDC-1 was observed. Patients who met the criteria of ΔPPV≥7.6% and LCR≥14.6% demonstrated a higher survival rate compared to other groups (Log-rank test: χ²=6.489, P<0.011).Microcirculatory disorders are closely linked to glycocalyx shedding. ΔPPV, particularly when combined with LCR, can effectively predict early organ function deterioration and has significant prognostic value for hospital mortality.