Effect of fluid resuscitation under PICCO monitoring on TcPO2,SvO2,SChE levels and prognosis in patients with septic shock
Objective To explore the effect of fluid resuscitation under pulse indicator continuous cardiac output(PICCO)monitoring on transcutaneous partial pressure of oxygen(TcPO2),venous oxygen saturation(SvO2)and serum cholinesterase(SChE)in patients with septic shock.Methods A total of 94 patients with septic shock in the Peking University International Hospital were selected as the research subjects and were divided into observation group and control group with 47 cases in each group according to the random number table method.The observation group adopted conventional method to monitor fluid resuscitation effect,and the observation group was given PICCO for fluid resuscitation effect monitoring.Hemodynamic parameters[TcPO2,SvO2,mean arterial pressure(MAP),central venous pressure(CVP)],therapeutic effect[fluid volume,urine volume,blood lactate level,actue physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score],clinical treatment time(mechanical ventilation time,fluid resuscitation time,vasoactive drug treatment time,ICU stay)and prognosis were compared between both groups.Results Compared with before treatment,after treatment,TcPO2,SvO2,MAP,and CVP in both groups were significantly increased(P＜0.05),and the observation group was higher than the control group,with statistically significant differences(t=3.765,4.137,3.616,6.935;all P＜0.05).Urine volume and SChE level in both groups were significantly enhanced(P＜0.05)while blood lactate and APACHE Ⅱ score were significantly reduced(P＜0.05),and the urine volume and SChE level in observation group were significantly higher(t=4.514,3.000;all P＜0.05)while blood lactate and APACHE Ⅱ score were significantly lower than those in control group(t=4.062,3.015;all P＜0.05).The mechanical ventilation time,fluid resuscitation time,vasoactive drug treatment time and ICU stay in observation group were significantly shorter than those in control group(t=3.750,7.270,2.177,3.559;all P＜0.05).The success rate of clinical resuscitation in observation group was significantly higher than that in control group(x2=4.967,P＜0.05),and the proportion of secondary pulmonary edema was significantly lower than that in control group(x2=4.919,P＜0.05).There was no statistical significance in mortality between the two groups(P＞0.05).Conclusion Fluid resuscitation therapy under PICCO guidance could significantly improve the hemodynamics,oxygen metabolism and tissue blood perfusion of patients,and it had high success rate of resuscitation and fast clinical recovery.
Septic shockFluid resuscitationPulse index continuous cardiac outputTranscutaneous partial pressure of oxygenVenous oxygen saturationCholinesterase
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