摘要
Abstract
Objective:To investigate the clinical effect of pulse indicator continuous cardiac output(PICCO)guided fluid resus-citation in patients with severe pneumonia and septic shock.Methods:A total of 107 patients with severe pneumonia and septic shock were divided into observation group(n =54)and control group(n =53)according to different treatment methods.The observation group was guided by PICCO for fluid resuscitation,while the control group was guided by conventional observation of central venous pressure,mean arterial pressure,mixed venous oxygen saturation and other indicators for fluid resuscitation.The heart rate and blood pressure,oxygenation index,fluid infusion volume and positive balance volume,serum inflammatory and myocardial injury indicators and clinical outcomes were compared between the two groups.Results:There was no significant difference in heart rate(HR),mean arteri-al pressure(MAP)and oxygenation index between the two groups at 6,12 and 24 h after resuscitation(P>0.05).At6 h of resuscita-tion,there was no significant difference in the amount of fluid infusion and positive fluid balance between the two groups(P>0.05).The amount of fluid infusion and positive fluid balance at 12 and 24 h after resuscitation in the observation group were less than those in the control group(P<0.05).The levels of serum inflammatory indexes interleukin-6(IL-6),interleukin-1β(IL-1β),tumor necro-sis factor-α(TNF-α),creatine kinase isoenzyme(CK-MB),cardiac troponin T(cTnT)and brain natriuretic peptide(BNP)in the observation group were lower than those in the control group at 24 h after resuscitation(P<0.05).The lactate clearance rate at6 h of resuscitation in the two groups was higher than that in the control group,and the recovery rate at 24 h of resuscitation was higher than that in the control group(P<0.05).There was no significant difference in mechanical ventilation time,ICU time and28-day mortality between the two groups(P>0.05).Conclusion:PICCO-guided fluid resuscitation in patients with severe pneumonia and septic shock can improve hemodynamics and respiratory circulation.Compared with conventional goal-directed guidance,PICCO-guided fluid resusci-tation can accelerate lactate clearance,improve resuscitation compliance rate,reduce cumulative fluid infusion,and reduce inflammatory response and myocardial injury.关键词
重症肺炎/感染性休克/液体复苏/脉搏指示连续心排血量Key words
Severe pneumonia/Septic shock/Fluid resuscitation/Pulse indicates continuous cardiac output分类
医药卫生
