The value of pulse-indicate continuous cardiac output in septic shock patients

Objective To investigate the value of pulse-indicate continuous cardiac output(PICCO) in septic shock patients.Methods In a retrospective study,58 patients who were diagnosed to be suffering from septic shock in the intensive care unit (ICU) were enrolled,from January 2010 to December 2011,and were divided into two groups:PICCO group(n =28) and the conventional group (n =30).We compared their 6 h-EGDT compliance rate,the level of lactate and central venous pressure (CVP),the oxygenation index,the characteristics of fluid intake and balance within 72 hours,duration of mechanical ventilation,and ICU stay of the two groups.The incidence of MODS after 72 hours in ICU,28-day mortality were recorded and compared.Results (1) Fluid intake((9565 ±1623) ml vs (12245±2253) ml,t=2.673,P=0.021) and balance ((3656 ± 1904) ml vs (5465 ± 2765) ml,t =2.357,P =0.012) were significantly lower in PICCO group compared the conventional group within 72 hours.(2) The oxygenation index ((252.6 ± 87.4) vs (226.8 ± 69.4),P ＜ 0.05) in PICCO group increased significantly and duration of mechanical ventilation ((134.7 ±42.8) h vs (193.3 ± 92.4) h,t =1.356,P =0.023) reduced significantly compared with the conventional group after 72 hours.(3) There was no difference in the 6 h-EGDT compliance rate,the level of lactate and CVP,6 h EGDT,ICU stay,the incidence rate of MODS after 72 hours,28-day mortality in ICU(P ＞0.05).Conclusion In contrast with classic methods as CVP monitoring,PICCO catheter may assess more accurately the volume status and guide early fluid resuscitation in septic shock patients. Key words: Septic shock;  Pulse-indicate continuous cardiac output;  Fluid resuscitation