Clinical value of pulse indicator continuous cardiac output monitoring in treating acute kidney injury due to sepsis / 新乡医学院学报

ABSTRACT

Objective To evaluate the clinical value of pulse indicator continuous cardiac output monitoring in treating acute kidney injury(AKI) due to sepsis.Methods Sixty-two patients with AKI due to sepsis in the Central Hospital of Zhumadian from August 2013 to August 2016 were rolled in and divided into control group (34 cases) and observation group (28 cases) according to whether adopted pulse indicator continuous cardiac output monitoring.Six hours and 24 hours after fluid resuscitatinn,resuscitation fluid volume,heart rate(HR),central venous pressure(CVP),mean arterial pressure(MAP),vasoactive drugs dose of the two groups were observed.Treatment times,daily filtration volume of continuous renal replacement therapy and independent urine volume,serum creatinine level,the survival rate after treating for seven days in the two groups were compared.Results There was no significant difference in the HR,central venous pressure,mean arterial pressure at six hours after fluid resuscitation between the two groups(P ＜ 0.05).At 24 hours after fluid resuscitation,there was no siguificant difference in the HR in the control group compared with that at six hours after fluid resuscitation (P ＜ 0.05),the CVP and MAP were higher than those at six hours after fluid resuscitation(P ＜ 0.05);the HR in the observation group was lower than that at six hours after fluid resuscitation (P ＜ 0.05),MAP was higher than that at six hours after fluid resuscitation (P ＜0.05),but there was no significant difference in the CVP in the control group compared with that at six hours after fluid resuscitation (P ＜ 0.05).The HR and CVP at 24 hours after fluid resuscitation in the observation group were lower than those in the control group(P ＜0.05),while there was no no significant difference in the MAP between the two groups(P ＜ 0.05).There was no significant difference in the fluid resuscitation volume,the dose of noradrenaline and dobutamine after treating for six hours between the two groups (P ＜ 0.05).Twenty four hours after fluid resuscitation resuscitation fluid volume and dobutamine dose in the observation group were significantly lower than those in the control group (P ＜ 0.05).The duration of renal replacement therapy,the daily filtration volume and the blood creatinine after treating for seven days in the observation group were significantly lower than those in the control group (P ＜ 0.05),but the independent urine volume after treating for seven days in the observation group was significantly higher than that in the control group (P ＜ 0.05).After treating for seven days,there were 28 cases survival,the survival rate was 82.4％ (28/34),while there were 25 cases survival,the survival rate was 89.3％ (25/28);the difference of survival rate between the two groups was not statistically significant (x2 =0.59,P ＜ 0.05).Conclusion In patients with AKI due to sepsis,pulse indicator continuous cardiac output monitoring can be used to optimize fluid management,and it can improved the renal function.