Application of pulse indicator continuous cardiac output in fluid management of patients with severe head injury

Objective To explore the clinical application of pulse indicator continuous cardiac output( Pi CCO) method in the fluid management of patients with severe head injury. Methods Fifty patients with severe craniocerebral injury in ICU were enrolled and divided into three groups by the random number table. The fluid management was guided by Pi CCO method in the experimental group( 17 cases),estimation of the central venous pressure( CVP) in the control group A( 17cases),and noninvasive cerebrovascular Blood-Dynamics Analyzer( CBA) in the control group B( 16 cases). The time stayed in ICU,Glasgow coma scale,incidence of neurogenic pulmonary edema and mortality rate in patients were compared among the three groups. Results 1The time stayed in ICU was( 9. 32 ± 2. 91) d in the experimental group,which was significantly shorter than( 15. 27 ± 4. 12) d in control group A and( 16. 29 ± 2. 96) d in control group B,the difference was statistically significant( P 0. 05); There was no statistically difference between the control group A and B( P 0. 05); 2 After the treatment,the Glasgow coma scale( GCS) was improved in all three groups. GCS score in the experimental group( 13. 12 ± 1. 15) increased more significant as compared with the control group A( 9. 41 ± 4. 28) and the control group B( 9. 41 ± 3. 96),the difference was statistically significant( P 0. 05); There was no statistically significant difference between the control group A and B( P 0. 05); 3After the treatment,the incidence of neurogenic pulmonary edema was 3. 3% in the experimental group,that was significantly lower than the control group A( 10%) and B( 10%),the difference was statistically significant( P 0. 05); The mortality rate in patients was 3. 3% in the experimental group,which was significant lower than the control group A( 6. 7%) and B( 6. 7%),the difference was statistically significant( P 0. 05). Conclusion Pi CCO can accurately and completely show the hemodynamic indexes of patients. The parameters in Pi CCO can be used to the blood management for patients,reduce the stay time of patients in ICU,improve the Glasgow coma score,and decrease the incidence of neurogenic pulmonary edema and mortality rate in patients,which is very helpful for the blood management in patients with severe craniocerebral injury.