Effect of Completion Time of Fluid Resuscitation of Septic Shock on the Outcome of the Disease
ZHANG Li
ZHENG Xiangde
TIAN Lin
Abstract：Objective To explore the effect of completion time of fluid resuscitation of septic shock on the outcome of patients'disease.Methods A total of 156 patients with septic shock admitted from July 2020 to July 2023 were divided into<1 h group(n =68),1-2 h(n =57)and≥2 h group(n =31)according to the completion time of fluid resuscitation.Acute physiological and chronic health status score(APACHEⅡ),sequential organ failure score(SOFA),hemodynamic in-dicators[Central Venous pressure(CVP),cardiac index,systemic vascular resistance index(SVRI),stroke volume index(SVI)],blood lactic acid,pH value,arterial partial oxygen pressure(PaO2),partial pressure of carbon dioxide(PaCO2),extravascular lung water index(ELWI),pulmonary vascular permeability index(PVPI),serum creatinine,fluid resuscitation volume,and dose of norepinephrine applied,length of stay in intensive care unit(ICU),mechanical ventilation time,and 28-day survival rate of the three groups were compared before and after fluid resuscitation.Results The scores of APACHEⅡand SOFA in<1 h group and1-2 h group were lower than those in≥2 h group(P<0.05).There were no significant differ-ences in APACHEⅡ and SOFA scores between<1 h group and 1-2 h group after resuscitation(P>0.05).After resuscita-tion,CVP,cardiac index and SVI in<1 h group and1-2 h group were higher than those in≥2 h group,and SVRI was lower than those in≥2 h group(P<0.05).There were no significant differences in CVP,cardiac index,SVRI and SVI between<1 h group and1-2 h group after resuscitation(P>0.05).The blood lactic acid of<1 h group and 1-2 h group after resus-citation was lower than that of≥2 h group(P<0.05).There was no significant difference in blood lactic acid between<1 h group and 1-2 h group after resuscitation(P>0.05).There were no significant differences in pH,PaO2 and PaCO2 among the three groups after resuscitation(P>0.05).ELWI,PVPI and serum creatinine in<1 h group were higher than those be-fore resuscitation,and higher than those in 1-2 h group and≥2 h group(P<0.05).There was no significant difference in 1 h liquid resuscitation volume among the three groups(P>0.05),and the 3 h liquid resuscitation volume of<1 h group,1-2 h group and≥2 h group showed a decreasing trend successively(P<0.05).The dose of norepinephrine in≥2 h group was higher than that in<1 h group and 1-2 h group(P<0.05)and the length of ICU stay and mechanical ventilation time in<1 h group were longer than those in 1-2 h group and≥2 h group(P<0.05).The 28-day survival rate of 1-2 h group and≥2 h group was higher than that of<1 h group(P<0.05,P<0.01).Conclusion The initial fluid resuscitation of septic shock patients should be completed within 1-2 h,which can effectively improve the organ dysfunction and severity of disease,maintain the hemodynamic level,accelerate the recovery process and promote the favorable outcome of the disease.
Keywords：ShocksepticFluid resuscitationTime limit for completionCentral venous pressureBlood lactic acidArterial partial pressure of oxygenNoradrenalineSurvival rate
Publication Date：2024-03-22
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 83-88 )