| Traumatic shock is cause of the body is subjected to intense fight against violence, leading to important organs injury, severe bleeding, make the effective circulating blood volume decreased, the micro circulation organization ring hypoperfusion, and compensatory form severe pain, fear and so on the many kinds of factors of post-traumatic disorders syndrome. The incidence rate of injury, and the nature of the injury site, bleeding degree, physiological status and early after injury management. With the development of modern production and living has been rapid development, severe multiple injury incidence is increasing, the incidence of traumatic shock is increased. Early traumatic shock exists more effective circulating blood volume is insufficient, if not treated in time, can lead to significant organ perfusion, increased anaerobic metabolism, lactic acidosis, reperfusion injury and endotoxin translocation, eventually leading to multiple organ failure and death. If the fluid too much too soon, will increase the burden on the heart, causing severe edema in various organs, prolonged EICU duration of hospitalization, increased mortality, so looking for a quick, effective monitoring method for fluid resuscitation in patients with multiple injury is very important.Pulse indicator continuous cardiac output(PICCO) monitoring technology is a new technology developed in recent years is the monitoring of cardiac preload, which combines by transpulmonary thermodilution technique and arterial pulse waveform area under curve analysis technology, and after a series of experiments. It is an invasive hemodynamic monitoring means, has been a lot of scholars have proved to be reproducible and more sensitive. Capacity index PICCO(ITBV, EVLW) to more accurately reflect the preload of the heart and lung water, effectively guide the liquidmanagement, cardiovascular fitness, intrathoracic pressure, valvular regurgitation has no effect on it, a method and can be used as assisting diagnosis, assessment of the disease, but PICCO needs to buy center venous catheter and femoral arterial catheter,the operation is relatively complex, invasive, expensive, difficult to widely use in clinic. Color Doppler ultrasound Heartbeat diagram of monitoring is a non-invasive,rapid, convenient, cheap, can check the method with good reproducibility, but its reliability, accuracy needs to be confirmed. This research mainly through comparison of hemodynamic monitoring results of the two methods, the analysis of pulse indicator continuous cardiac output(PICCO) and bedside ultrasound assessment of patients with traumatic shock Heartbeat diagram of liquid reactive fluid resuscitation,clinical value guidance.Objective to study and analysis of pulse indicator continuous cardiac output(PICCO)and Beckoning variation of hemodynamics in patients with traumatic shock Doppler ultrasound monitoring graph control study, observation of pulse indicator continuous cardiac output monitoring(PICCO) technique application in fluid resuscitation in patients with traumatic shock. Methods retrospective study from 2014 June to 2014 December, the selection of EICU in our hospital admitted 40 patients received mechanical ventilation in the treatment of patients with traumatic shock, the selected patients were randomly divided into experimental group(group PICCO) and control group(group CDE) with 20 cases in each. PICCO group of PICCO artery catheter was placed via the femoral artery, internal jugular vein or subclavian vein placed three lumen central venous catheter. Changes in experimental group was applied PICCO on hemodynamics monitoring and management of early active liquid capacity, control group application of CDE examination to a liquid treatment management. Recording two groups of fluid resuscitation before treatment and after treatment 24 h, 72 h of HR,CVP, mean arterial pressure(MAP), oxygenation index(Pa02/Fi02), ventilator time,EICU time. |
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