Comparative Study Of Echocardiography And PiCCO On Evaluation Of Circulatory Function In Patients With Septic Shock

Objective: Comparison of Echocardiography and PiCCO in the Evaluation of circulatory function in patients with septic shock.Methods: Selected from October 2016 to December 2018,20 patients with septic shock in the Department of Intensive Critical Care,Third Hospital of Hebei Medical University,After PiCCO hemodynamic monitoring,At 0h,6h,12 h,24h,The cardiac output and stroke volume were measured by the PiCCO and echocardiography at the same time;Giving rehydration test for 20 patients after entering the room,500 ml Sodium acetate Ringer injection was infused for the patients by vein rapidly in 30 minutes,the change of SV before and after rapid infusion was taken as the index.SV?10% was volumeresponsive group,and SV<10% was non-volume-responsive group.the sensitivity and specificity of dIVC and SVV were analysised by the receiver operating characteristic curve(ROC curve).Results:1.There was no significant difference in SV and CO between PiCCO and echocardiography measured at 0h,6h,12 h and 24h(P>0.05);2.Correlation analysis:0h SV(echocardiography)and SV(PiCCO)correlation coefficient is 0.741,0h CO(echocardiography)and CO(PiCCO)correlation coefficient is 0.680;6h SV(echocardiography)and SV(PiCCO)correlation coefficient is 0.651,6h CO(echocardiography)and CO(PiCCO)correlation coefficient is 0.541;12h SV(echocardiography)and SV(PiCCO)correlation coefficient is 0.658,12 h CO(echocardiography)and CO(PiCCO)correlation coefficient is0.671;24h SV(echocardiography)and SV(PiCCO)correlation coefficient is 0.695,24 h CO(echocardiography)and CO(PiCCO)correlation coefficient is 0.722;3.ROC curve for SVV and dIVC predictive capacity reactivity: ROC curve analysis results show,The area of ROCdIVC,ROCSVV were 0.763± 0.114,0.899±0.083 respectively,and 95% confidence interval were0.522 to 0.921,0.682 to 0.987 respectively.The sensitivity of responsiveness was predicted SVV was 11%(sensitivity was 72.73%,specificity was 100%),and the RVI was 19.6%(sensitivity was 63.64%,specificity was 88.89%).Conclusion: Echocardiography and PiCCO had a good correlation with SV,CO in the heart of septic shock patients at different time and after different treatment.Both dIVC and SVV could reflect the volume response of septic shock patients.Noninvasive monitoring of circulatory function in septic shock patients by echocardiography can replace invasive PiCCO monitoring to a certain extent.