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Clinical study of serum index variation and prognostic relevance in the application of PiCCO monitoring technology in fluid resuscitation of infectious shock |
Zhou Lin, Wang Ji-wen, Chen Liang, Zhou Ming-gen, Zou Zi-jun, Li Wei-chao, He Zhi-jie |
Intensive Care Unit, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China |
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Abstract Objective To explore the clinical study of serum index variation and prognostic relevance in the application of pulse indicator continuous cardiac output(PiCCO) monitoring technology in fluid resuscitation of infectious shock. Methods 126 cases of infectious shock in our hospital from May 2012 to March 2016 were selected and divided into the control group (63 cases) and the treatment group (63 cases). The treatment group was performed early goal-directed therapy (EGDT) under the PiCCO monitoring technology, while the control group adopted the conventional treatment and was conducted EGDT under central venous pressure (CVP) monitoring. The various indicators before and after treatment, and the correlation between monitoring indicators of PiCCO, serum markers and mortality rate were analyzed. Results After fluid resuscitation for 72 hours, APACHEⅡ score, SOFA score, serum Cys C and β2-MG level in the two groups decreased significantly compared to before fluid resuscitation (P<0.05), the lactate clearance rate and oxygenation index in PiCCO group were both significantly higher than those in control group (P<0.05) , and the total of fluid resuscitation in PiCCO group was significantly less than that in control group (P<0.05). Compared with control group, mechanical ventilation time, ICU admission days were shorten, and 28-day sepsis occurrence rate and fatality rate were significantly lower(P<0.05). There were significant differences of pretherapeutic EVLWI, CI, PVPI, serum Cys C and β2-MG between two groups (P<0.05). There was a significant negative correlation between CI and mortality rate (r=-0.273, P<0.05) , and there was a significant positive correlation between EVLWI, PVPI , serum Cys C and β2-MG and mortality rate (r=0.752, 0.818, 0.729, 0.804, P<0.05).Conclusion PiCCO monitor blood flow index to guide clinical treatment of septic shock has clinical good effects, PiCCO monitor indicators such as CI, PVPI and EVLWI and serum markers show a close correlation with the prognosis of patients with septic shock, thus should be widely applied.
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Corresponding Authors:
He Zhi-jie, E-mail: 25038506@qq.com
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