| With the development of transportation and building industry, Multiple injuries has become one of three major killers threating people’s lives and healthy, It is common critical ill in ICU,50%to70%of patients with multiple trauma, shock, multiple organ failure is the leading cause of death in trauma patients. Multiple trauma patients have three died peaks:The first Death peak within minutes after injury,About50%of deaths. The second Death peak in6～8h after injury, About30%of deaths. If the rescue is promptly, the majority of the patients can be exempt from death, called gold1h [l], The presence of effective hypovolemia in severe trauma early stage, If not promptly treated, Can cause significant tissue and organ hypoperfusion. Increased anaerobic metabolism, lactic acidosis, reperfusion injury and endotoxin translocation, and ultimately lead to multi-organ failure and death. If excessive fluid will increase the burden on the heart, causing severe swelling of the organs, prolonged hospitalization, increased mortality, and therefore looking for a quick and effective method for monitoring patients with multiple trauma guide fluid resuscitation is crucial.Continuous monitoring of cardiac output pulse indication (PICCO) technology is a combination of lower temperatures pulmonary arterial pulse waveform dilution technique and area under the curve analysis and correction after a series of experiments, a resulting invasive hemodynamic monitoring tools. PICCO relatively minimally invasive, low technical barriers to entry, has been proven by many scholars may be more sensitive and reproducible. PICCO capacity index (ITBV, EVLW) compared to conventional pressure index (CVP, PAWP), to more accurately reflect cardiac preload and lung water more effectively guide fluid management, cardiovascular compliance, intrathoracic pressure, valvular regurgitation had no effect on them, and as assist in the diagnosis, a method of assessing the disease, is being increasingly widely used in clinical and research work, especially for patients with severe hemodynamic parameters of the main tools for monitoring, a simple, minimally invasive characteristics.Objective To investigate the pulse indicates continuous monitoring of cardiac output (PICCO) technology in patients with multiple trauma resuscitation of application results. Methods36cases of multiple trauma patients were randomly divided into treatment group and control group18cases. Treatment group is placed through the femoral artery catheter PICCO artery via the internal jugular vein or subclavian vein placement or triple lumen central venous double-lumen catheter, through the guidance of the dynamic changes PICCO indicators fluid resuscitation; Control group of central venous catheters, central venous pressure to guide fluid resuscitation according to (CVP), blood lactate, heart rate (HR) and urine output and so on. Record two groups before treatment (TO) and6h after treatment (T1),12h (T2),24h (T3) of HR, CVP, mean arterial pressure (MAP), oxygenation index (PaO2/FiO2),72h the amount of fluid resuscitation, ventilator time, ICU length of stay,28d in the mortality rate. Results When HR groups were higher than TO T1, T2, T3, the treatment group T2, HR T3were lower than the control group when, P<0.01; When two TO CVP, MAP, PaO2/FiO2were lower than T1, T2, T3, the treatment group T2, CVP T3when, MAP were lower than the control group, treatment group T2, T3were higher than the point PaO2/FiO2the control group, P<0.01.72h the amount of fluid resuscitation therapy group (14451.7±162.9) mL, ventilator time (7.1±3.57) h, ICU length of stay (9.5±3.92) d,28d mortality rate of11.1%in the control group, respectively (21520.6±178.2) mL,(15.2±3.79) h,(22.1±4.15) d,22.2%, P<0.05. Conclusions PICCO technology can effectively guide fluid resuscitation of multiple trauma patients, reducing the amount of liquid72h of recovery, shorter ventilator time and ICU length of stay, reduce mortality. |
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