Clinical study of capacity index monitoring by PiCCO in fluid resuscitation in septic shock patients

Objective To investigate the value of fluid resuscitation strategy in septic shock patients by pulse indicator continuous cardiac out （ PiCCO ） .Methods 42 septic shock patients were divided into the PiCCO group（n=26） and the control group（n=16）.All patients measured heart rate（HR）,mean artery pressure（MAP）, central venous pressure（CVP）;CI,GEDVI,SVRI,EVLWI,CVP as indicator of fluid resuscitation after 0h,6h,24h of the diagnosis were measured respectively in PiCCO group;CVP as guiding volume resuscitation was measured in the control group .The effect of fluid resuscitation was compared between two groups .To analyse the relationship between CVP,GEDVI and CI in PiCCO group .according to CVP increase 2mmHg ,GEDVI whether elevated 10%.Results After 6h EGDT treatment bundle HR ,MAP,APACHEII score and clearance rate of lactic in PiCCO group improved more than those in control group [（101.3 ±7.8） and （119.4 ±7.2）,t=-7.520,P 0.05;（53.6 ±11.5） and （-16.5 ±5.2）,t =9.283,P 0.05）,but ICU hospitalization time decreased in PiCCO group [（13.8 ±2.6） and （23.3 ±2.2）,t=-5.075,P 0.05）.Conclusion Hemodynamic monitoring by PiCCO directed fluid resuscitation strategy can elevate reversal rate .Compared with pressure index CVP ,GEDVI is a sensitive indicator of cardiac preload .Correlation between CVP and GEDVI can reflect cardiac function ,Especially for septic shock patients with cardiac depression . Key words: Shock septic; Resuscitation; Central venous pressure; Global end-diastolic volume index