The Clinical Efficacy of Restrictive Fluid Resuscitation Under Pulse-Indicated Continuous Cardiac Output(PiCCO)Guidance in the Management of Traumatic Shock in the Emergency Setting

XUE Fei; SHI Yanhua

doi:10.16458/j.cnki.1007-0893.2025.01.003

Abstract：Objective To analyze the application value of restrictive fluid replacement under pulse indicator continuous cardiac output monitoring(PiCCO)in the treatment of emergency traumatic shock.Methods A total of 99 patients with emergency traumatic shock admitted to Nanyang Central Hospital from January 2023 to August 2024 were selected as the research subjects and divided into group A,group B and group C by the envelope method,with 33 cases in each group.Group A underwent conventional fluid resuscitation,group B underwent restrictive fluid resuscitation,and group C underwent restrictive fluid resuscitation under PiCCO monitoring.The hemodynamic indicators,clinically relevant recovery indicators,coagulation function indicators and complication rates of the three groups were compared.Results Comparison of mean arterial pressure(MAP)among the three groups:Before resuscitation,there was no statistically significant difference among the three groups(P>0.05).At 6 hours and 24 hours after resuscitation,all three groups increased,and the difference was statistically significant(P<0.05),and group C was the highest in all cases.However,only at 6 hours after resuscitation,There was a statistically significant difference among the three groups(P<0.05).Comparison of central venous pressure(CVP)among the three groups:Before resuscitation,there was no statistically significant difference among the three groups(P>0.05).At 6 hours and 24 hours after resuscitation,all three groups increased,and the difference was statistically significant(P<0.05),and group C was the highest.However,there was no statistically significant difference among the groups(P>0.05).The correction time of traumatic shock,the clearance time of lactic acid,and the 24-hour infusion volume in group C were all shorter or less than those in group A and group B,and the 24-hour urine volume was greater than that in group A and group B.The differences were statistically significant(P<0.05).At 12 hours after resuscitation,the prothrombin time(PT),partial thromboplastin time(APTT),and thrombin time(TT)in all three groups increased,but those in group C were lower,and the differences were statistically significant(P<0.05).The incidence of complications in group C was lower than that in group A and group B,and the difference was statistically significant(P<0.05).Conclusion When performing fluid resuscitation on patients with traumatic shock in the emergency department,restrictive fluid resuscitation under PiCCO monitoring can be more conducive to promoting the recovery of patients and reducing the impact on coagulation function,with high safety.