Effect of early goal directed therapy on the PCT and prognosis in severe sepsis patients

FAN Rui; DAI Xiaoyong; YANG Xiaoying; ZHU Yichuan; YE Youwen; YUAN Jia

doi:10.3969/j.issn.1671-6450.2015.09.019

Abstract：Objective To investigate the early goal directed therapy ( EGDT) on severe sepsis patients ’ serum calci-toninpeptide(PCT)levels.Methods 58 cases of severe sepsis patients were randomly divided into EGDT group and control group with 29 cases in each group .Both of the 2 groups were received active control of infection , mechanical ventilation and other basic treatment , the EGDT group received early recovery as the key part of the comprehensive treatment , the control group received conventional treatment , such as circulation and capacity support .The different admission time , serum PCT lev-el, APACHE II score, recording rate and 28 day mortality incidence of EGDT standard time , 7 days of acute kidney injury (AKI) and multiple organ failure (MODS) were compared between the two groups , and the correlation among the indexes were analyzed.Results The 2 groups’ 3, 5, 7 days’ PCT levels were lower than the admission ( P <0.05), after 3 days, 5 days, 7 days of admission , EGDT group of patients with PCT levels were significantly lower than those of the control group (P<0.05);the EGDT group’s patients who with less than or equal to 6 h standards, when admitted to hospital at 5 days, 7 days, the PCT level was significantly lower than those whose >6 h standards ( P <0.05);the EGDT group of patients ’ 7 days’ APACHE II score and MODS incidence, 7 days’ AKI incidence was significantly lower than that of control group (P <0.05);7 days’ APACHE II score and MODS incidence, 7 days AKI incidence rate were positively correlated with PCT (r=0.651, r =0.401, r =0.395, P <0.05).Conclusion Severe sepsis patients should received EGDT as early as possi-ble, it can rapidly reduce serum PCT levels , improve prognosis , and is closely related to the standard time .