Efficacy of PiCCO monitoring in guiding volume therapy in patients with sepsis complicated with acute kidney injury

Abstract

Objective To evaluate the efficacy of pulse indicator continuous cardiac output (PiCCO) monitoring in guiding volume therapy in patients with sepsis complicated with acute kidney injury. Methods Eighty-five patients with sepsis complicated with acute kidney injury were divided into PiCCO group (n=37) and routine group (n=48) according to whether PiCCO monitoring was used to guide volume therapy.The hemodynamic parameters at 6 and 24 h after volume therapy, fluid volume, consumption of vasoactive drugs, renal function, fatality in intensive care unit and 28-day fatality were recorded. Results Compared with routine group, the volume of fluid for resuscitation at 24 h after volume therapy, and central venous pressure were significantly decreased (P<0.05), the time of continuous renal replacement therapy was shortened, the urine volume was increased, the blood creatinine level was decreased, and the fatality rate in intensive care unit and 28-day fatality rate were decreased in group PiCCO (P<0.05). Conclusion For the patients with sepsis complicated with acute kidney injury, PiCCO monitoring can reasonably guide volume therapy and is helpful in improving the prognosis. Key words: Cardiac output; Catheterization, Swan-Ganz; Monitoring, physiologic; Sepsis; Fluid therapy; Acute kidney injury