Effect of PICCO-guided limited fluid resuscitation combined with temperature management in pre-hospital emergency treatment for patients with septic shock
Objective To explore the effect of pulse indicator continuous cardiac output(PICCO)-guided limited fluid resuscitation(LFR)combined with temperature management in pre-hospital emergency treatment for patients with septic shock(SS).Methods A total of 96 SS patients admitted to the Emergency Department of 901 Hospital of the PLA JLSF were retrospectively enrolled between January 2021 and June 2023.they were divided into PICCO group(n=52)and routine group(n=44)based on pre-hospital emergency management.All patients were managed by routine temperature management,and those in PICCO group and routine group additionally received PICCO-guided limited fluid resuscitation and conventional fluid resuscitation,respectively.The clinical data in the two groups were collected.The heart rate(HR),mean arterial pressure(MAP),central venous oxygen saturation(ScvO2),blood lactic acid(LAC),endothelin-1(ET-1),interleukin 10(IL-10),Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE-Ⅱ)score,Sequential Organ Failure Assessment(SOFA)score,duration of mechanical ventilation(DMV),length of stay in the ICU,mortality were compared between groups.Results After treatment,significantly lower HR,significantly higher MAP and ScvO2,significantly less resuscitative fluid,significantly lower levels of LAC,ET-1,IL-10,significantly decreased scores of APACHEⅡ and SOFA,significantly shorter DMV and length of stay in the ICU were found in PICCO group than those of routine group(all P＜0.05).The mortality in PICCO group was significantly lower than that in routine group(P＜0.05).Conclusion PICCO-guided LFR combined with temperature management in pre-hospital emergency treatment for SS patients can effectively improve body circulation,reduce inflammatory factors,improve clinical effects and prognosis.
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