Clinical application of cardiopulmonary capacity monitor PiCCO in monitoring the hemodynamics of patients with serious burn

Objective To investigate the feasibility of application of cardiopulmonary capacity monitor PiCCO in monitoring the hemodynamics of patients with serious burn in shock stage and perioperative periods.Methods Ten seriously burned patients with 82.5%±15.7% total body surface area burn and hospitalized from May 2008 to Nov.2008 were involved in the present study.All the patients underwent eschar excision within 3 days of hospitalization,and the hemodynamic indexes were monitored by PiCCO in the shock stage and perioperative period,including mean arterial pressure(MAP),cardiac index(CI),cardiac function index(CFI),intrathoracic blood volume index(ITBI),systemic vascular resistance index(SVRI),and extravascular lung water(EVLW).Monitoring was performed 6 times in shock stage and 10 times in perioperative period.Results All the catheters were successfully introduced,and the indwelling time was 3.0±0.4d.No complication due to catheterization occurred,and the bacterial cultivation was negative in all patients.The levels of CI,CFI and ITBI oarered markedly,and that of SVRI elevated in shock stage and then returned to normal level after fluid resuscitation(P0.05).No significant change was found in the levels of MAP and EVLW after burn and resuscitation(P0.05).During the perioperative period,the hemodynamic indexes of the patients were stable with careful cardiopulmonary capacity monitoring by PiCCO(P0.05),except the SVRI reduced and CFI elevated after eschar excision(P0.05).Conclusion Hemodynamic monitoring with PiCCO in shock stage and perioperative period for seriously burned patients is safe and feasible,and helpful for fluid resuscitation therapy and the maintenance of stable vital signs.