Guiding significance of pulse-induced continuous cardiac output technology for fluid management of patients with severe pneumonia
GUO Ying-jun
MENG Fan-su
WANG Guo-jun
LIU Ba-yi
CEN Ying-wen
ZHOU Dan-dan
Abstract：Objective To analyze the guiding significance of the pulse indicate continuous cardiac output (PiCCO) technology for fluid management of patients with severe pneumonia in ICU.Methods From November 2010 to August 2011 in ICU in our hospital,15 cases of severe pneumonia treated with PiCCO were included(PiCCO group),and another 15 cases treated with CVP monitoring alone during the same period were included in CVP group.Separately clinical pulmonary infection score (the CPIS) was recorded and end-diastolic volume (GEDV),intrathoracic blood volume (ITBV),pulse pressure variation rate (PPV),extravascular lung water (EVLW) and central venous pressure (CVP) at 24,48 and 72 hours were recorded.The relationship of GEDV,ITBV,CVP,EVLW and the oxygenation index was calculated.Results In the PiCCO group,oxygenation index of 48 hours and 72 hours was significantly higher than that in CVP group [(157 ± 43) vs (83 ± 39),(216 ± 40) vs (163 ± 37)],and blood lactate and CPIS were lower than thaose in CVP group [blood lactate:(2.4 ± 0.6) mmol/L vs (3.0 ±1.1) mmol/L (1.1 ± 0.5) mmol/L vs (2.5 ± 0.8) mmol/L; CPIS:(5.3 ± 1.7) scores vs (6.4 ± 2.1) scores,(3.1 ± 1.5) scores vs (5.3 ± 1.6) scores],and the differences were statistically significant (P ＜ 0.05).The total intake and fluid balance amount of the PiCCO group was significantly less than those in CVP group in 48 hours,72 hours [total intake:(2836 ±291)ml vs (3351 ±510)ml,(2510 ±203)ml vs (2981 ±301)ml; amount of fluid balance:(251 ± 147)ml vs (764 ±211)ml,(217 ±212)ml vs (443 ± 176)ml respectively,all P＜0.05].Ventilator time and length of ICU of the PiCCO group were significantly less than those in CVP group [(11 ± 4) d vs (18 ± 5) d,(13 ± 5) d vs (19 ± 5) d,respectively,P ＜ 0.05] ; Hospitalization costs of two groups was not statistically significant (P ＞0.05).The correlation coefficients of GEDV with CVP and ITBV with CVP were-0.134,-0.145,the correlation was weak (P ＞ 0.05).At 48 hours and 72 hours,the correlation coefficients of EVLW and the oxygenation index were-0.414,-0.465,and the correlation was strong(P＜0.05).Conclusions It is helpful to know the fluid resuscitation of severe pneumonia with PICCO.PiCCO can reduce the total fluid volume,improve oxygenation index,reduce the time of ventilator and shorten the length of ICU stay.
Keywords：Pulse indicates the continuous cardiac emissions technologyCentral venous pressure measurementPneumonia,severeFluid management
Publication Date：2013-03-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：3( 332-334 )