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| Clinical application of GEDVI combined with SVV in the fluid resuscitation for elderly septic shock patients |
| Tan Li-duan, Geng Yong-zhi, Chen Zhi-guo |
| Department of Emergency, Chengde City Central Hospital, Chengde 067000, China |
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Abstract Objective To analyze the clinical application of global end-diastolic volume index (GEDVI) combined with stroke volume variation (SVV) in the fluid resuscitation for elderly septic shock patients. Methods A total of 64 ICU patients with septic shock treated from September 2014 to September 2016 in our hospital were selected. The subjects were randomly divided into two groups, 32 cases each group. The control group received the fluid resuscitation with the sepsis bundles; the observation group received the fluid resuscitation with the GEDVI combined with the SVV. The mechanical ventilation time, hospitalization time in the ICU room, acute physiology and chronic health evaluationⅡ(APACHEⅡ) scores, 6 h blood lactic acid levels and positive fluid balance were observed. Results The positive fluid balance for observation group was statistically increased after 6 h of treatment and reduced after 24 h, 48 h and 72 h of treatment than control group (P<0.05). The MAP was gradually increased at different time points in observation group (P<0.05), the MAP was higher than that in the control group at different time points. In control group, the MAP at 24 h was lower than 6 h, but was gradually increased at 24 h, 48 h, 72 h (P<0.05). Noradrenaline accumulation and lactate were significantly lower at different time points, LCR was statistically higher at different time points. Compared with the control group, noradrenaline accumulation and lactate were lower at different time points (P<0.05). Pcv-aCO2 in the observation group was lower than that in control group at 6 h, 24 h(P<0.05), but there were no significant differences at different time points in the observation group (P>0.05). In the control group, Pcv-aCO2 was lower at 72 h than that after treatment at 48 h (P<0.05). Compared with the control group, BE were significantly higher at 6 h, 24 h. The mechanical ventilation time and hospitalization time in the ICU room for observation group were statistically shortened; the APACHEⅡ scores, dobutamine application rate, heart and respiratory failure rate in the observation group were statistically reduced than the control group (P<0.05). The 28 day survival rate showed significantly higher than the control group (P<0.05). The incidence of kidney injury had no difference (P>0.05). Conclusion GEDVI combined with SVV directed fluid resuscitation can rapidly and accurately predict the fluid responsiveness and volume status, which can also effectively maintain the best status of blood volume and recover tissue perfusion. They can reduce the heart and respiratory failure rate, improved the patient's prognosis and survival rate.
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Corresponding Authors:
Chen Zhi-Guo, E-mail: yxwtld@163.com
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