| Objective:Cardiac function in early sepsis can be changed,as the severity of cardiac dysfunction,the mortality is also increasing. Therefore, to prevent the occurrence and development of cardiac dysfunction,on the treatment of sepsis has an important clinical significance, but first of all as the prerequisite of cardiac function monitoring technology and indicators development it provides a basis for clinical intervention.Currently there are many alternative techniques and indicators in monitoring cardiac function in patients, thoracic electrical bioimpedance measured non-invasive cardiac output because of its non-invasive simple,convenient,economical, is currently gaining more and more clinical applications,also becomes an important means of monitoring blood flow dynamics when being changes of cardiac function in patients with sepsis. Many studies have already confirmed that procalcitonin (PCT) is an important diagnostic indicators of infection and sepsis, Serum PCT concentration is proportional to infection, the severity and the level of activity of sepsis, can be used for monitoring treatment and prognosis of infection and sepsis. In this study, by dynamic monitoring of cardiac function in thoracic electrical bioimpedance in patients with sepsis and the determination of PCT, studying the changes in serum PCT, the relationship between the PCT and cardiac function and analysising significance of monitoring of thoracic electrical bioimpedance measured non-invasive cardiac output changes in cardiac function in patients with sepsis.Methods:Selected the total 65 patients treated in the First Affiliated Hospital of Dalian Medical University, Emergency wards and emergency intensive care unit (EICU) in May 2009-February 2010,30 of which are patients with sepsis, the other 35 cases are non-sepsis,in sequence recorded age, sex and general condition. First Oh (admission instantly)determine serum PCT targets, while at the same time monitor heart function in patients in thoracic electrical bioimpedance, continuously monitoring 10 set of data, record the cardiac index (CI), while monitoring 10 cardiac cycles with color Doppler echocardiography,and record ejection fraction (EF). At admission 24h, record PCT, CI, EF of patients in the same way.First of all, respectively in Oh and 24h compare the correlation of CI measrued in thoracic electrical bioimpedance measured non-invasive cardiac output and EF measured in color Doppler ultrasound of two groups. And compare the differences of EF,CI between sepsis group and non-sepsis group within groups respectively at Oh,24h two-time. At Oh and 24h, respectively, analysis of the correlationin of PCT and CI in patients.Finally compare the differences of EF,CI between sepsis group and non-sepsis group among groups at Oh,24h two-time Data results are applied by SPSS 16.0 statistical software for statistical analysis, p<0.05 as statistically significant difference, p<0.01 as statistically significant difference.Results:In all patients at Oh (admission immediately) and the 24h there is a good correlation between CI measrued in thoracic electrical bioimpedance and EF measured in color Doppler ultrasound of two groups and is positive correlation, correlation coefficient r=0.967, p<0.01;r= 0.977, p<0.01.PCT in sepsis patients have significant differences compared Oh with24h (p<0.01),with statistical significance; CI in sepsis patients have significant differences compared Oh with 24h (p<0.01),with statistical significance.PCT in nonsepsis patients at Oh and 24h there was no significant difference(p=0.057>0.05),no statistical significance; nonsepsis patients at Oh and 24h CI was no significant difference (p=0.969>0.05),no statistical significance.Oh PCT in patients was negatively correlated with CI(r=-0.759, p<0.01); 24h PCT in patients with a negative correlation with CI (r=-0.792, p<0.01).0h compared the PCT of sepsis group with nonsepsis group there were significantly different (p<0.01), the difference has statistical significance; 24h compared the PCT of sepsis group with nonsepsis group there were significantly different (p<0.01), statistical significance.Oh compared the CI of sepsis group with nonsepsis group there were significantly different (p<0.01), the difference has statistical significance.24h compared the CI of sepsis group with nonsepsis group there were significantly different (p<0.01), the difference has statistical significance.Conclusions:In the early stage of sepsis cardiac functio damage occurred in patients. As the disease progress,the heart failure has been increas-ing.there is a good correlation between CI measrued in thoracic electrical bioimpedance and EF measured in color Doppler ultrasound in terms of cardiac function monitoring and evaluation in septic patients. In the changes of cardiac function,it also has better monitoring and evaluation, so it can be used to warn the changes of cardiac function in early sepsis.Serum PCT was consideredas a indicator to reflect disease progression in sepsis patients,serum PCT levels in sepsis patients increased rapidly, the more serious the condition is,the higher PCT levels are. |
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