|
|
|
|
|
The the optimal scheme of the EGDT for severe sepsis and septic shock |
YU Chen-bin,NI Hai-bin,LIU Ke-qin,HU Xing-xing,HONG Zu-jian. |
Department of Emergency Medicine,Jiangsu Province Hospital on Integration of Chinese and Western Medicine,Nanjing 210028,China |
|
|
Abstract Objective According to the fluid management method(four distinct phases or stages of resuscitation: rescue,optimization,stabilization,and de- escalation,ROS- D)raised by the 12th acute
dialysis quality initiative(ADQI)conference,we want to describe and compare this management
with the early goal-directed resuscitation(EGDT)for severe sepsis and septic shock,and assess the
safety and effectiveness in the treatment of sepsis shock. Methods This retrospective study
included 63 cases of sepsis shock,we divided the patients into EGDT group and optimize management group(ROS-D group). We recorded and compared the hemodynamic changes,the volume of intravenous fluids and the related laboratory tests,etc between the two groups. Results In the process of fluid resuscitation,no significant differences were found in CVP,lactic acid and APACHEⅡ(P>0.05). After 6 hour,the MAP was statistically different. The following indexes including the volume of fluid,
fluid balance,mechanical ventilation time and norepinephrine used time in the ROS-D group were better than those in the EGDT group(P<0.05). Conclusion The ROS-D method is safe and effective,and should be administered for resuscitation in severe sepsis and septic shock.
|
Received: 06 July 2015
|
Corresponding Authors:
NI Hai-bin,E-mail: nhb_2002@126.com
|
|
|
|
[1] Hosted EA,Maitland K,Brunei CS,et al. Four phases of intravenous fluid therapy: a conceptual model[J].
Br J Anaesth,2014, 113(5): 740-747.
[2] Douglas JJ,Walley KR. Fluid choices impact outcome in septic shock[J]. Curr Opin Crit Care,2014,20(4): 378-384.
[3] Vincent JL,De Backer D. Circulatory shock[J]. N Engl J Med,2013,369(18): 1726-1734.
[4] 张淑文,苏强,王超,等. 感染性休克患者的病死率和危险因素研究[J]. 创伤外科杂志,2007,9(1): 8-10.
[5] Alsous F,Khamiees M,DeGirolamo A,et al. Negative fluid balance predicts survival in patients with
septic shock: a retrospective pilot study[J]. Chest,2000,117(6): 1749-1754.
[6] 刘红梅,孙海晨. 创伤性休克复苏的研究进展[J]. 创伤外科杂志,2011,13(1): 78-81.
[7] Kelm DJ,Perrin JT,Cartin-Ceba R,et al. Fluid overload in patients with severe sepsis and septic shock
treated with early goal-directed therapy is associated with increased acute need for fluid-related medical
interventions and hospital death[J]. Shock,2015,43(1): 68-73. |
|
|
|