Value of Dynamic Bedside Ultrasound IVC and Variability Rate Combined with CVP in Monitoring Fluid Resuscitation of Septic Shock Patients
Objective:To investigate the value of dynamic bedside ultrasound inferior vena cava(IVC)and variability combined with central venous pressure(CVP)for monitoring fluid resuscitation in patients with septic shock.Methods:Ninety-two patients with septic shock were selected and divided into observation group(46 cases)and control group(46 cases)according to random number table method.The control group was guided by liquid resuscitation therapy based on CVP monitoring,and the observation group was guided by dynamic bedside ultrasound IVC and variability rate combined with CVP monitoring.The hemodynamic pa-rameters[heart rate(HR),MAP,CVP,lactic acid(LAC)]the degree of condition[acute physiology and chronic health score(APACHE Ⅱ),sequential organ failure score(SOFA)]of the two groups before treat-ment and 72h of treatment;statistic patients'24h resuscitation fluid volume,ICU hospitalization time,resusci-tation attainment rate of 6h,24h and 72h of treatment,28d morbidity and mortality rates were compared.Re-sults:After treatment,HR and LAC of both groups decreased compared with the pre-treatment period,and the observation group was lower than the control group,and MAP and CVP of both groups increased compared with the pre-treatment period,and the observation group was higher than the control group(P<0.05).After treatment,APACHE Ⅱ score and SOFA score of both groups decreased compared with the pre-treatment,and the observation group was lower than the control group(P<0.05).The amount of resuscitation fluid and ICU hospitalization time of the observation group were lower than those of the control group(P<0.05).At 72h of treatment,the resuscitation compliance rate of the observation group was higher than that of the control group(P<0.05).Comparing the 28d morbidity and mortality rates of the two groups,the difference was not statistically significant(P>0.05).Conclusion:Fluid resuscitation of septic shock patients under dynamic bedside ultrasound IVC and variability combined with CVP monitoring improves hemodynamics,reduces the volume of resuscitated fluids,shortens ICU length of stay,improves resuscitation attainment,and promotes re-gression.
万方数据
维普
