摘要
Abstract
Objective:To explore the application effect of cardiopulmonary ultrasound monitoring in fluid management of patients with severe sepsis.Method:A total of 70 patients with severe sepsis admitted to Department of Critical Care Medicine,Ji'an Central People's Hospital from May 2021 to October 2023 were selected and divided into observation group(n=35,cardiopulmonary ultrasound monitoring to guide fluid management)and control group[n=35,pulse indicator continuous cardiac output(PiCCO)to guide fluid management]by simple randomization method.The recovery situation[intensive care unit(ICU)stay time,mechanical ventilation time],28 d fatality,and respiratory function[central venous pressure(CVP),oxygenation index,static lung compliance(Cst),positive end-expiratory pressure(PEEP),plateau pressure(Pplat)],cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)],the scores of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA)before and after treatment were compared between the two groups.Result:There was no significant difference in 28 d fatality rate between the two groups(P>0.05).Compared with the control group,the mechanical ventilation time and ICU stay time in the observation group were shorter,the differences were statistically significant(P<0.05).After 3 d of treatment,CVP,oxygenation index and Cst in observation group were higher than those in control group,and PEEP and Pplat were lower than those in control group,the differences were statistically significant(P<0.05).After 3 d of treatment,LVEF in observation group was higher than that in control group,LVEDV and LVESV were lower than those in control group,the differences were statistically significant(P<0.05).After 3 d of treatment,the scores of APACHE Ⅱ and SOFA in both groups were decreased,and the scores of APACHE Ⅱ and SOFA in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The application of cardiopulmonary ultrasound monitoring in fluid management of patients with severe sepsis can effectively improve the cardiopulmonary function,alleviate the condition and improve the prognosis.关键词
心肺联合超声/重度脓毒症/液体管理/中心静脉压Key words
Cardiopulmonary ultrasound/Severe sepsis/Liquid management/Central venous pressure
