PiCCO Predictive Value Of Capacity Responsiveness In Septic Shock Therapy

Objection:To discuss the predictive value of volumetric reactivity in the treatment process of cardiac output pulse contour temperature dilution continuous flow measurement instrument(Pi CCO)in the treatment of patients with Septic shock.Method:This study income in August 2015 to January 2016 in hebei university hospital intensive care unit(ICU),88 cases of infection in patients with toxic shock,selects the Pi CCO(pulse indicates a continuous cardiac output monitor)and CVP(central venous pressure)continuous monitoring into the group of patients rehydration hemodynamic parameters before and after the test.In addition,the growth value of the cardiac output index after the rehydration test was defined as the reaction group(the capacity response was positive),and the volume reaction negative(no response group)was defined as the△CI<10%.Evaluation of the above two groups patients rehydration test before and after the central venous pressure(CVP),heart rate(HR),stroke,quantitative change thin(SVV),mean arterial blood pressure(MAP),cardiac index(CI)and the change of the monitoring indicators values(delta CVP,delta HR,delta SVV,MAP for delta,delta CI)difference,then analysis these values and cardiac blood index growth delta(CI).In addition,ROC curve was developed to evaluate the predictive value of the above monitoring indexes on the patients’ liquid capacity reactivity.Results:1.In the 88 patients who were admitted to the group,there were 148 rehydration tests,of which 65 had capacity reactivity and 83 cases without capacity reactivity.2.There was no statistically significant difference between the central venous pressure(CVP),heart rate(HR),mean arterial pressure(MAP),and cardiac index(CI)between the two groups before the rehydration test.However,the reactive group of each of the strokevolume variation(SVV)was significantly higher than that in the non-reactivity group(p<0.05).3.After rehydration experiment was carried out,the presence of reaction between the two groups of patients with central venous pressure(CVP),heart rate(HR),stroke volume variation(SVV),mean arterial pressure(MAP)there were no statistically significant difference,but there is response group of cardiac blood index was significantly greater than no reaction group(p < 0.05).4.There was no statistically significant difference between the patients in the two groups after the rehydration test and the non-reactive group.However,there was a significant greater than the absence of reactive groups in the reactivity group.[△SVV,p<0.05;△CI,p<0.05。]5.There was no correlation between the central venous pressure(CVP),heart rate(HR)and average arterial pressure(MAP)before the rehydration test.However,there was a linear correlation(r=0.850,p<0.05)for each of their varying degrees of variability(SVV)and the increase of cardiac output index.The area under the working trait curve was0.9483.When 14.8% is the best critical value,its sensitivity is 85.43%,and its specificity is 86.64%.Significantly greater than other hemodynamic monitoring targets(such as central venous pressure,heart rate,mean arterial pressure).Conclusion:In this paper,the parameters of hemodynamics were monitored by using the pulse contour temperature dilution continuous flow measurement instrument.Stroke quantity thin(SVV)can more exactly feedback from infection,acute toxic shock patients capacity status,the raise in the treatment of infection in patients with Septic shock in the process of the management of capacity.