Effects of early fluid resuscitation on extravascular lung water of elderly patients with septic shock

【Objective】 To determine the effect of fluid resuscitation on haemodynamic and extravascular lung water(EVLW) of elderly patients in early stage of septic shock.【Methods】 Twenty-two elder1y patients with septic shock were randomly divided into group A(n =11) and group B(n =11).Patients of two groups were given fluid resuscitation by early goal-directed therapy(EGDT).Group A was given fluid resuscitation of 6%hydroxyethyl starch130/0.4(VOLUVEN)-0.9%NaCl solution and group B of 0.9%NaCl solution.The data of haemodynamic and extravascular lung water was collected at the point before fluid resuscitation and 6 hour,24 hour,48 hour after the beginning of fluid resuscitation.【Results】 Fluid resuscitation significantly improved the hemodynamics of two groups' patients with septic shock.Blood lactic acid(Lac) decreased significantly after fluid resuscitation in both groups(P 0.05).Intrathoracic blood volume index(ITBVI) of the patients in group A significantly increased more early(6 hour) compared with patients in group B(P 0.05).There was no change in PVPI,EVLWI in the course of fluid resuscitation of two groups(P 0.05).EVLWI of group B significantly increased 48 hour after beginning of fluid resuscitation(P 0.05).EVLWI was not significantly correlated with GEDVI,ITBVI,PO2/FiO2,but positively correlated with PVPI(group A: r =0.823,P 0101,group B: r =0.629,P 0.01).【Conclusion】 Fluid resuscitation of both colloid and crystalloid could improved the hemodynamics of septic shock in critical patients.But colloid could better remain colloid osmotic pressure and expend blood volume compared with crystalloid.EVLW maybe increase in fluid resuscitation of crystal in elder1y patients with septic shock.