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| Relationship between fluid resuscitation under PICCO in different time and the prognosis of patients with septic shock |
| HAN Shasha, ZHAI Nailiang, XU Ling, TIAN Huanhuan |
| Department of Respiratory and Critical ICU, Binzhou Medical University Hospital, Binzhou 256603, P.R.China |
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Abstract Objective To observe and evaluate the effect of different fluid resuscitationstandard time on the prognosis of patients with septic shock under the guidance of PICCO monitoring. Methods A retrospective study was used. The patients divided into 0~6 h standard group and 6~12 h standard group according to the different time when ITBVI reached 850~1 000mL/m2 monitored by PICCO. Blood gas analysis, lactic acid, SOFA scorewere recorded at 6 h, 12 h, 24 h and 48 h after admission, length of stay in ICU, mechanical ventilation time, and the fatality rate at 7 and 28 days were recorded. Results After 24 h of treatment, lactic acid and SOFA scores in the 0~6 h group were significantly lower than those in the 6~12 h group, and the fatality rate was significantly reduced at 28 days. Compared with the 6~12 h standard group, patients in the 0~6 h standard group had shorter mechanical ventilation time, shorter time in ICU, and less 7-day mortality, but the difference was not statistically significant. After treatment, the indexes of oxygenation index and lactic acid in both groups were better than those at 0 h. Conclusion Fluid resuscitation therapy for patients with septic shock under the guidance of PICCO monitoring can significantly reduce SOFA score and 28-day mortality after reaching the standard at 6 h compared with 12h. Both 6 h and 12 h ITBVI reaching 850~1 000 mL/m2 can improve the prognosis of patients.
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Received: 18 March 2019
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[1] 王助衡, 张静, 李玉伟, 等. 严重脓毒症液体复苏中全心舒张期末容积指数与中心静脉压的相关性研究[J]. 中国中西医结合急救杂志, 2013, 20 (4): 248-249.
[2] Litton E, Morgan M. The PiCCO monitor: a review[J]. Anaesth Intensive Care, 2012, 40(3): 393-409.
[3] 邱合信. PICCO监测技术在脓毒症性休克患者液体复苏中的临床意义[J]. 中国实用医药, 2013, 8(35): 79-80.
[4] 王荣辉, 林正佳. PiCCO监测技术在严重脓毒症患者输液管理中的作用分析[J]. 中外医学研究, 2013, 11(16):153-154.
[5] 卢年芳, 郑瑞强, 林华, 等. PiCCO指导下集束化治疗感染性休克的临床研究[J]. 中华危重病急救医学, 2014, 26(1): 23-27.
[6] 罗淞元, 李小霞, 王喜梅. 脉搏指示连续心排出量监测在脓毒症急性肾损伤治疗中的应用价值[J]. 新乡医学院学报, 2018, 35(3): 231-234.
[7] 宋志, 赵秀, 侯明晓, 等. 胸腔内血容量指数及中心静脉血氧饱和度在创伤性休克早期液体复苏中的应用研究[J]. 临床急诊杂志, 2013, 14(11): 510-513.
[8] Annane D, Siami S, Jaber S, et al. Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with hypovolemic shock: the CRISTAL randomized trial[J]. JAMA, 2013, 310(17) : 1809-1817.
[9] Patel A, Laffan M A, Waheed U, et al. Randomized trials of human albumin for adults with sepsis: systematic review and meta-analysis with trial sequential analysis of all-cause mortality[J]. BMJ, 2014, 349: 4561.
[10] 王逸君, 徐自强, 屈双权, 等. PICCO指导严重脓毒症和脓毒性休克患者临床救治的应用研究[J]. 实用休克杂志(中英文), 2017, 1(2): 101-105.
[11] 董双雄, 沈辉, 陈世明. PICCO监测下脓毒性休克早期液体复苏的临床疗效分析[J]. 当代医学, 2017, 23(21): 98-99. |
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