Application of NICOM combined with intensive care ultrasound in volume management after cardiac surgery
Objective To explore the efficacy of noninvasive cardiac output monitoring(NICOM)combined with intensive care ultrasound in volume management of patients with hemodynamic disorders after cardiac surgery.Methods Ninety-one patients with hemodynamic disorders after cardiac surgery admitted to Zhejiang Provincial People's Hospital from January to October 2021 were selected as study objects,and were divided into control group(n=46)and observation group(n=45)according to random number method.The control group underwent traditional hemodynamic monitoring to guide fluid management.In observation group,the volume management strategy based on NICOM combined with intensive care ultrasound guided fluid management.The duration of tracheal intubation removal,left ventricular ejection fraction(LVEF),brain natriuretic peptide(BNP),postoperative lactic acid normalcy time,diuretic use rate,postoperative urine volume,incidence of acute heart failure,intra-aortic balloon pump retention rate,mechanical ventilation duration and intensive care unit(ICU)stay were compared between two groups.Results The proportion of patients with successful extubation in observation group was significantly higher than that in control group(χ2=14.773,P=0.001).At discharge,LVEF in both groups was significantly higher than that at admission,BNP was significantly lower than that at admission(P<0.05).LVEF in observation group was significantly higher than that in control group,and BNP was significantly lower than that in control group(P<0.05).The time of lactic acid normalization,mechanical ventilation duration and ICU stay in observation group were significantly shorter than those in control group,diuretic use rate,cumulative fluid balance volume and incidence of acute heart failure were significantly lower than those in control group,and the postoperative urine volume was significantly higher than that in control group(P<0.05).Conclusion The volume management strategy based on NICOM combined with intensive care ultrasound can significantly reduce the amount of fluid replenishing in patients with hemodynamic disorders after cardiac surgery,improve cardiac function and shorten the time of mechanical ventilation,which is worthy of clinical promotion and application.
Noninvasive cardiac output monitoringIntensive care ultrasoundHaemodynamicsVolume management
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