Application of pulse indicator continuous cardiac output monitoring in the fluid management of children with acute respiratory distress syndrome

Abstract

Objective To explore the application value of pulse indicator continuous cardiac output (PiCCO) monitoring in the fluid management of children with acute respiratory distress syndrome(ARDS). Methods Thirty-two children with ARDS admitted to Pediatric Intensive Care Unit(PICU) of Zhengzhou Children′s Hospital, from April 2013 to April 2016, were divided into intervention group (15 cases) and control group (17 cases) by adopting random number table method.Fluid management of intervention group by PiCCO, control group by central venous pressure, the 2 groups′ oxygenation index (OI), acute lung injury score, mechanical ventilation time and 28 days mortality were statistically compared.The categorical data were analyzed by using SPSS 11.0 software, and the t test was used for the mea-surement data.The categorical data and mortality comparison were analyzed by adopting χ2 test.The difference was statistically significant at P<0.05. Results After 3 days of mechanical ventilation, the changes of OI in the intervention group were significantly higher than those in the control group [(175.0±43.7) mmHg vs.(143.0±42.8) mmHg(1 mmHg=0.133 kPa), t=2.090 0, P 0.05). Conclusions PiCCO monitoring and guidance in the fluid management of pediatric ARDS can improve oxygenation after 3 days, reduce mechanical ventilation time, but can not significantly reduce the 28-day mortality. Key words: Pulse indicator continuous cardiac output; Acute respiratory distress syndrome; Mortality; Extravascular lung water; Fluid management