UTI Influence On Microcirculation In Patients With Acute Circulatory Failure Caused By Infection

Objective:To explore whether UTI can improve microcirculation in patients with acute circulatory failure caused by infection and thereby to improve their prognosis.Methods:(1)Collect 50 patients with acute circulatory failure caused by infection which were admitted to intensive care unit in Affiliated Hospital of Qingdao University during 2018-5 to 2019-12.They were randomly divided into 25 control group and 25 UTI group,the control group received conventional treatment,and the UTI group on the basis of conventional therapy plus UTI.(2)Using LH-SDF-1 type SDF observer(Xuzhou Lihua Electronic Technology Development Co.,Ltd.)to observe control group and UTI group patients'sublingual microcirculation at the time point of 0h,3h,6h,12h,24h,48h,72h,then calculate microvascular flow index(MFI),total vessel density(TVD),perfused vessel density(PVD),proportion of perfused vessels(PPV).(3)Statistics of the two groups 72 hours?SOFA,30 day fully-cause mortality respectively.(4)Independent samples t-test was performed for each group of quantitative data by the software of spss 22nd edition.?~2 test was used to compare rates for each group.P<0.05 was considered statistically significant.Results:(1)The results show that baseline,3 hours'and 6 hours'microcirculatory perfusion index(microvascular flow index,MFI;total vessel density,TVD;perfused vessel density,PVD;proportion of perfused vessels,PPV)between UTI group and control group is no significant difference.(2)The 12 hours microvascular flow index(MFI)in the UTI group is higher than the control group(2.56±0.19 VS 2.43±0.32),however,no statistically significant(P=0.09,t=-1.740).Other 12 hours microcirculation index(total vessel density,TVD;perfused vessel density,PVD;proportion of perfused vessels,PPV)are no difference between UTI group and control group.(3)The 24 hours microvascular flow index(MFI)in the UTI group is higher than the control group(2.85±0.14 VS 2.44±0.31),and the difference is statistically significant(P=0.009,t=-6.018).Other 24 hours microcirculation index(total vessel density,TVD;perfused vessel density,PVD;proportion of perfused vessels,PPV)are no difference between UTI group and control group.(4)The 48 hours microvascular flow index(MFI)in the UTI group is higher than the control group(2.92±0.17 VS 2.49±0.30),and the difference is statistically significant(P=0.043,t=-6.185).The 48 hours total vessel density(TVD)in the UTI group is higher than the control group(11.58±0.61 VS 10.70±0.87),and the difference is statistically significant(P=0.030,t=-4.114).The 48 hours perfused vessel density(PVD)in the UTI group is higher than the control group(7.00±0.95 VS 5.73±0.71),and the difference is statistically significant(P=0.027,t=-5.336).The 48 hours proportion of perfused vessels(PPV)in the UTI group is higher than the control group(0.603±0.057 VS0.532±0.034),and the difference is statistically significant(P=0.004,t=-5.333).(5)The 72 hours microvascular flow index(MFI)in the UTI group is higher than the control group(3.03±0.13 VS 2.54±0.29),and the difference is statistically significant(P=0.001,t=-7.591).The 72 hours total vessel density(TVD)in the UTI group is higher than the control group(11.86±0.58 VS 10.83±0.84),and the difference is statistically significant(P=0.024,t=-5.083).The 72 hours perfused vessel density(PVD)in the UTI group is higher than the control group(7.41±1.01 VS 5.89±0.75),and the difference is statistically significant(P=0.032,t=-6.073).The 72 hours proportion of perfused vessels(PPV)in the UTI group is higher than the control group(0.623±0.059 VS0.543±0.036),and the difference is statistically significant(P=0.006,t=-5.812).(6)The 72 hours?SOFA in the UTI group is higher than the control group(-1.92±1.38 VS-0.48±1.98,a negative value indicates decline when compared with baseline and a positive value indicates increase when compared with baseline).And the30-day mortality rate in UTI group is 8%(2 patients are dead)and in control group is24%(6 patients are dead),but the difference is no significant(?~2=2.38,P=0.123).Conclusion:Compared with the conventional control group,plus UTI can improve24 hours microvascular flow index(MFI)in patients with acute circulatory failure caused by infection,and can improve all microcirculation indicators in patients with acute circulatory failure caused by infection after dosing UTI for 48 hours.It can also improve72 hours SOFA scores obviously thereby improving the prognosis of 30 days.