Application of Fluid Management Based on Pulse Indicator Continuous Cardiac Output Monitoring in Sepsis-induced Shock Complicated with Acute Respiratory Distress Syndrome

doi:10.16048/j.issn.2095-5561.2025.04.15

Abstract：Objective To explore the application effect and prognosis of fluid management based on pulse indicator continuous cardiac output monitoring (PICCO) in patients with septic shock complicated with acute respiratory distress syndrome (ARDS). Methods A total of 126 patients with septic shock complicated with ARDS admitted to the First Affiliated Hospital of Air Force Medical University from June 2021 to June 2023 were selected. There were 76 males and 50 females, with a mean age of (50.32±2.22) years (age range 35–72 years). Patients were randomly divided into a study group (n=63) and a conventional group (n=63) according to different fluid management methods. Both groups received symptomatic treatment. The conventional group received conventional fluid management, while the study group received fluid management based on PICCO technology. The differences in fluid resuscitation-related indicators, cardiopulmonary function, hemodynamic parameters, serum indicators, and prognosis between the two groups were compared. Results There was no statistically significant difference in fluid intake at 6 hours of fluid resuscitation between the two groups (P>0.05). However, the study group had lower dopamine and norepinephrine doses and lactate levels than the conventional group, and higher fluid intake and urine output at 24 hours of fluid resuscitation, with statistically significant differences (P<0.05). The study group showed higher global end-diastolic volume index, cardiac output index, intrathoracic blood volume index, oxygenation index, central venous pressure, mean arterial pressure, and systemic vascular resistance index, and lower extravascular lung water index and pulmonary vascular resistance index than the conventional group, with statistically significant differences (P<0.05). Repeated measures ANOVA results showed that tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1) levels decreased at 3 days and 7 days compared to day 0, while interleukin-10 (IL-10) increased, with statistically significant differences (P<0.05). The study group showed better TNF-α, IL-1, and IL-10 levels at 3 days and 7 days compared to the conventional group, with statistically significant differences (P<0.05). The study group had shorter mechanical ventilation time, ICU stay, and improved APACHE II scores after treatment compared to the conventional group, with statistically significant differences (P<0.05). Conclusion Fluid management based on PICCO technology has good effects in patients with septic shock complicated with ARDS, effectively improving cardiopulmonary function and hemodynamics, reducing serum inflammatory markers, and improving prognosis.