Abstract:Objective: To investigate the application of Pulsed Wave Indicating Continuous Cardiac Output Monitoring (PICCO) technology in fluid resuscitation from multiple trauma patients. Methods: 80 patients with multiple traumatic fluid resuscitation who were admitted from March 2017 to March 2018 were randomly divided into two groups. Patients in the control group were given traditional TTE and CVP monitoring. Patients in the PICCO group were treated with PICCO. The life related evidence and clinical observation index of the two groups during the monitoring period were compared. Results:The HR, CVP, MAP, CI, GEF, GEDVI, ITBVI, EVLWI, LAC, and APACHEII scores in the PICCO group were significantly lower than those in the control group at the time of T2 and T3, and the PaO2/FiO2 levels were significantly higher than those in the control group. The control group; 72h liquid volume, ventilator time, norepinephrine use, ICU time and mortality at 28 days were significantly lower than the control group, the difference was statistically significant (P<0.05). Conclusion:The application of pulse wave indication continuous cardiac output monitoring technique in fluid resuscitation of patients with multiple trauma is significant and has reference significance.
[1] 陈炜,臧学峰,牛素平,等.监测液体复苏前后血流动力学参数对脓毒性休克短期预后的早期预测价值[J].中华危重病急救医学,2015,27(1):43~47.
[2] 崔广清,冒秀宏,孙卫和,等.PiCCO指导重症患者液体管理及临床预后的评价[J].东南国防医药,2015,30(2):122~126.
[3] 卢年芳,郑瑞强,林华,等.PiCCO指导下集束化治疗感染性休克的临床研究[J].中华危重病急救医学,2014,26(1):23~27.
[4] Yuanbo Z,Jin W,Fei S,et al.ICU management based on PiCCO parameters reduces duration of mechanical ventilation and ICU length of stay in patients with severe thoracic trauma and acute respiratory distress syndrome[J].Ann Intensive Care,2016,6(1):113.
[5] 江家树,汤展宏,胡军涛,等.脉搏指示连续心输出量技术目标导向液体复苏治疗在烧伤早期中的应用研究[J].中国全科医学,2016,19(18):2151~2155.
[6] 汪润民,高萍,杨吉乡,等.PiCCO监测下的液体管理对老年急性呼吸窘迫综合征患者预后的意义[J].中国老年学杂志,2017,37(17):4325~4327.
[7] Sun Y,Lu Z H,Zhang X S,et al.The effects of fluid resuscitation according to PiCCO On the early stage of severe acute pancreatitis[J].Pancreatology,2015,15(5):497~502.
[8] Huber W,Phillip V,Hollthaler J,et al.Femoral indicator injection for transpulmonary thermodilution using the EV1000/volumeview((R)):do the same criteria apply as for the PiCCO(R)[J].Zhejiang Univ Sci B,2016,17(7):561~567.