Experimental Study Of Treating Heart Failure With Shenfu Injection And Assessment Of Clinical Prognosis With EVLWI

Using picco to evalate the effect of Shenfu injection on sheep model of acute heart failureObjective Apply the Pulse-indicated Continuous Cardiac Output(PiCCO) System to evaluate the effect of Shenfu injection on hemodynamics of acute heart failure(AHF) sheep model,including Intrathoracic Blood Volume Index,Extravascular Lung Water Index et al,and study the mechanism of Shenfu injection.Methods Four sheep were used in this study.We built the heart failure sheep model through the ligation of the diagonal artery of left anterior descending coronary artery,and then all the sheep were medicated with Shenfu injection (2ml/kg) plus 5%glucose solution to 250ml totally through intravenous drip. Central venous catheter was placed in the jugular vein and the PiCCO arterial catheter in the femoral artery.Both of them were connected to the ECG monitoring equipment with PiCCO module.We collected the data of Cardiac Output(CO),Cardiac Index(CI),Stroke Volume(SV),Mean Artery Pressure(MAP), Central Venous Pressure(CVP),Intrathoracic Blood Volume Index(ITBVI), Extravascular Lung Water Index(EVLWI),Global End-diastolic Volume Index (GEDVI) before AHF,30 minutes before and after AHF,1 hour after AHF,1.5 hours after AHF,2 hours after AHF.Results 1.Hemodynamic results:30 minutes after AHF,CO,CI,SV,MAP declined rapidly(0.5 hours before vs 0.5 hour after ALHF,P＜0.01).After the Shenfu injection was given,these parameters increased significantly in statistics at 1 hour after AHF(0.5 hour after vs 1 hour after AHF,P＜0.01).2.Other parameters:30 minutes after ALHF,GEDVI,ITBVI,EVLWI,CVP increased rapidly(0.5 hours before vs 0.5 hour after ALHF,P＜0.01).After the Shenfu injection was given,these parameters decreased significantly in statistics at 1 hour after AHF.CVP began to decrease at 1.5 hours after AMI, (0.5 hour after vs 1.5 hours after AHF,P＜0.01).Conclusion This study suggests that Shenfuinjection can significantly improve the hemodynamics of AHF sheep model,and provides the evidence of treating heart failure with Shenfu injection.The value of EVLWI to evaluate the prognosis in cr itically ill patientsObjective To study the value of EVLWI to evaluate the prognosis in critically by using PiCCO technology.Methods We analyzed of 38 ICU patients monitored by PiCCO system, retrospectively.They were divided into the death group and the survival group according to the prognosis.Their hemodynamic data were collected at Oh,24h, 72h.Their EVLWI were analyzed to find whether there were differences or not at every time point.According to EVLWI level when patients were admitted into ICU,they were divided into four groups(EVLWI≤7.0,7.0≤EVLWI＜12,12≤EVLWI＜15.0,EVLWI≥15.0),their mortality rates were calculated separately.Results Death group's EVLWI is higher than the survival group at 0 hour. There' s no significantly difference of EVLWI between death group and survival group at 24h and at 72h(P＞0.05).Mortality of EVLWI≤7.0 group is 21.43%, 50%in 7.0≤EVLWI＜12 group,69.23%in 12≤EVLWI＜15.0 group%,and 87.5%in EVLWI≥15.0 group.Conclusion This study suggests that early EVLWI measurement proves to be an indicators to evaluate the prognosis in critically ill patients,and the control of pulmonary edema later cannot improve patients' prognosis. Mortality increases along with EVLWI.