Efficacy of cardiopulmonary ultrasound in guiding volume therapy in patients with sepsis-induced myocardial injury

Abstract

Objective To evaluate the effect of cardiopulmonary ultrasound in guiding volume therapy in the patients with sepsis-induced myocardial injury. Methods Thirty-eight patients of both sexes with septic myocardial injury, aged 28-64 yr, weighing 60-90 kg, received anti-infection, respiratory and circulatory comprehensive treatment.The patients were divided into group Ⅰ (n=19) and group Ⅱ (n=19) by using a random number table method.Central venous pressure(CVP)was used to guide volume therapy, and fluid replacement was carried out using the CVP 2-5 principle in group Ⅰ.Cardiopulmonary ultrasound was used to guide volume therapy in group Ⅱ.Blood samples were taken before volume therapy and on 1, 3 and 5 days after volume therapy to determine the concentrations of N-terminal pro-B-type natriuretic peptide, cardiac troponin I and creatine kinase isoenzyme MB in serum.The CVP, positive fluid balance, lactic acid, central venous oxygen saturation and urine volume were recorded at 6, 24, 48 and 72 h after volume therapy.Left ventricular ejection fraction was recorded at 1, 3 and 5 days after volume therapy.The length of intensive care unit stay and 28-day fatality were recorded. Results Compared with group Ⅰ, the CVP and fluid positive balance were significantly decreased at each time point after volume therapy, the concentration of serum N-terminal pro-B-type natriuretic peptide was decreased at 5 days after volume therapy(P 0.05). Conclusion Cardiopulmonary ultrasound can reduce the volume of liquid infused, avoid fluid overload and avoid accentuating myocardial injury when used to guide volume therapy in the patients with sepsis-induced myocardial injury. Key words: Sepsis; Myocardium; Ultrasonography; Fluid Therapy