Comparison of central venous pressure and global end diastolic volume index predicting fluid responsiveness in mechanically ventilated patients with septic shock

Objective To assess fluid responsiveness in mechanically ventilated patients with septic shock by central venous pressure(CVP) and global end diastolic volume index(GEDVI).Methods Fifty-five mechanically ventilated patients with septic shock underwent 55 liquid load tests(LLT),within 30 minutes,the subjects received an intravenous infusion of 6 ml/kg of 6%hydroxyethyl starch(200/0.5).The CVP was monitored through a catheter introduced via the right internal jugular vein and the subclavian vein.The cardiac index(CI) and GEDVI before and after fluid loading were monitored by pulse-induced contour cardiac output(PiCCO).Positive fluid responsiveness was defined as an increase in CI(△CI) by 15%or more.Hemodynamic changes before and after LLT were observed and the correlations between CVP,GEDVI and ACI were assessed.Results The change rate of CVP after volume treatment of responders was higher than that of non-responders,but there was no significant difference(P 0.05).The change rate of GEDVI after volume treatment of responders was higher than that of non-responders,there was significant difference(P0.01).CVP and GEDVI before the resuscitation showed increase after the resuscitation.There was no significant correlation between ACVP and ACI,while there was positive correlation between AGEDVI and ACI(r = 0.816,P0.01).Conclusion Compared with CVP,GEDVI can better reflect cardiac preload in septic shock patients,and predict fluid responsiveness.