Abstract
This study aims to explore the changing characteristics of extravascular lung water after fluid resuscitation in septic shock patients by early PiCCO monitoring. 42 patients who were admitted to the ICU in our hospital and diagnosed as septic shock were collected. The patients were divided into two groups: treatment group (PiCCO group) (n=21) and control group (CVP group) (n=21). They were given early fluid resuscitation using different monitoring methods on the basis of conventional treatment for septic shock to monitor the changes of hemodynamics, EVLWI, oxygenation index (PaO2/FiO2) and BNP level before and after resuscitation. The BNP and LAC levels of the treatment group were significantly lower than those of the control group within 72 h (P 0.05). ITBVI and GEDVI immediately, 12 h and 24 h after the fluid resuscitation were increased in the two groups compared with those before, between which the difference was statistically significant (P 0.05). Early fluid resuscitation under the guidance of PiCCO has significant effect, which can be used as one of indicators for hemodynamic monitoring.
Highlights
Septic shock and its secondary multiple organ dysfunction syndrome (MODS) mainly lead to death in ICU wards, which bottleneck the development of critical care medical science at present
This study aims to compare the effects of early fluid resuscitation under the guidance of PiCCO capacity monitoring and central venous pressure (CVP) monitoring on the levels of blood-brain natriuretic peptide (BNP), lactic acid (LAC), time of vasoactive drug application and prognosis
The results show that intra-thoracic blood volume index (ITBVI) and global end-dilution volume index (GEDVI) immediately, 12 h and 24 h after fluid resuscitation were increased in the two groups compared with those before, between which the differences were statistically significant (P
Summary
Septic shock and its secondary multiple organ dysfunction syndrome (MODS) mainly lead to death in ICU wards, which bottleneck the development of critical care medical science at present. Hemodynamic changes are mainly featured in abnormal distribution of blood flow, resulting in significant insufficiency of effective circulating blood volume. How to provide patients with sufficient capacity to ensure adequate volume resuscitation while preventing pulmonary edema from aggravating is the difficulty of the hemodynamic management in critical care medicine [1, 2]. For patients with septic shock, early fluid resuscitation is one of the important measures for circulatory support, and especially early goal directed therapy (EGDT) can maintain stable circulation, and improve organ tissue perfusion and tissue oxygen supply. If fluid resuscitation is performed, there will be the risks of aggravated oxygen metabolism that deteriorates respiratory functions [3, 4]
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