Impact of early fluid resuscitation guided by bedside ultrasound on hemodynamics and endpoint events
OBJECTIVE To explore the effect of early fluid resuscitation guided by bedside ultrasound on treatment of patients with septic shock and observe the impact on hemodynamics and endpoint events.METHODS A total of 86 patients with septic shock who were treated in intensive care unit(ICU)of the Affiliated Hospital of Hangzhou Normal University from Jan 2019 to Dec 2022 were recruited as the research subjects and were divided into the control group with 42 cases and the experimental group with 44 cases according to the treatment approaches of early fluid resuscitation.The patients of the control group underwent the early fluid resuscitation under the guid-ance of pulse index continuous cardiac output(PICCO),and the patients of the experimental group received the early fluid resuscitation under the guidance of bedside ultrasound.The total volume of fluid was compared between the two group after the treatment for 24 and 48 hours;the levels of inflammatory factors,hemodynamics indexes and incidence of endpoint events were compared between the two groups before the treatment and after the treat-ment for 24 hours.RESULTS The fluid input volume and positive balance volume of the experimental group were lower than those of the control group after the treatment for 24 and 48 hours.The levels of serum procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)as well as the heart rate(HR)of the two groups were lower after the treatment for 24 hours than before the treatment(P＜0.05),and the levels of above indexes and HR of the experimental group were lower than those of the control group(P＜0.05).The central venous pressure(CVP),mean arterial pressure(MAP)and central venous oxygen saturation(ScvO2)of the two groups were higher after the treatment than before the treatment(P＜0.05),and the levels of above indexes of the experimen-tal group were higher than those of the control group(P＜0.05).The proportions of the patients who received continuous renal replacement therapy and had pulmonary edema within 3 days were lower in the experimental group than in the control group(P＜0.05);the mechanical ventilation duration and length of hospital stay of the experimental group were shorter thanthose of the control group(P＜0.05).CONCLUSION The early fluid resusci-tation guided by bedside ultrasound can effectively reduce the volume of fluid resuscitation of the patients with sep-tic shock,effectively regulate the levels of inflammatory factors and hemodynamics indexes,alleviate the inflam-mations and improve the hemodynamics so as to improve the clinical outcomes.
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NSTL
万方数据
维普
