Clinical Value Of Pulse Indicator Continuous Cardiac Output Monitoring Combined With Passive Leg Lift Test In Guiding Early Fluid Resuscitation In Septic Shock Patients

Objective:Fluid resuscitation is an important therapeutic measure in septic shock patients.The purpose of this study is to explore the clinical value of pulse indicator continuous cardiac output(Pi CCO)monitoring combined with passive leg lift test(PLRT)in early fluid resuscitation of septic shock,to provide theoretical basis for clinical treatment.Methods:60 patients with septic shock in Foshan Chancheng District Central Hospital from April 2016 to February 2019 were randomly divided into observation group(n=28)and control group(n=32)according to random number table method.The observation group was monitored with Pi CCO combined with PLRT,while the control group was monitored by central venous pressure(CVP).The total resus fluid,plasma levels of lactic acid(LAC)and B-type natriuretic peptide(BNP)were compared between the two groups at 6h,24 h,48h,72 h after treatment.The total urine volume,acute physical and chronic health evaluation Ⅱ(APACHE Ⅱ)score,oxygenation index were compared between the two groups after 72 hours,and the time of use of vasoactive drugs,duration of mechanical ventilation,length of stay in intensive care unit(ICU)and mortality rate of 28 days were compared between the two groups.Results:(1)There was no significant difference between the two groups in total resus fluid at 6h,24 h and 48h(P>0.05).However,the total resus fluid at 72 h in the observation group was lower than that in the control group,showing a statistical difference(P<0.05).(2)There was no significant difference in plasma LAC between the two groups at6 h 24h and 48h(P > 0.05),but the plasma LAC at 72 h in the observation group was lower than that in the control group(P < 0.05).(3)There was no significant difference in plasma BNP between the two groups at6 h and 24h(P > 0.05),but the plasma BNP at 48 h and 72 h in the observation group was lower than that in the control group(P < 0.05).(4)The APACHE Ⅱ score,oxygenation index in the observation group are better than the control group at 72 h later(P < 0.05),two groups of 72 hours total amount of urine is no statistical difference(P > 0.05).(5)The time of application of vasoactive drugs,duration of mechanical ventilation and hospitalization of ICU in the observation group were shorter than those in the control group.(P < 0.05),but there was no significant difference in 28-day mortality between the two groups(P > 0.05).Conclusion:Pi CCO combined with PLRT monitoring compared with CVP monitoring in patients with septic shock during early fluid resuscitation,the total resus fluid at 72 h was less,and has lower levels of LAC and BNP.After 72 hours,the APACHE Ⅱ score and oxygenation index were better,but there was no difference in the total amount of urine of72 h.And the time of application of vasoactive drugs,the duration of mechanical ventilation and the length of hospitalization of ICU were shorter,but there was no difference in mortality of 28 days.