Effect of modified early goal directed therapy on the prognosis of patients with septic shock / 重庆医学

ABSTRACT

Objective To evaluate the effects of modified early goal directed therapy (EGDT )on the prognosis of patients with septic shock .Methods Clinical data of 116 patients with septic shock admitted to ICU during January 2011 to March 2013 were retrospectively analyzed .Patients were divided into modified early goal‐directed therapy group (n=57) and traditional early goal‐di‐rected therapy group (n=59) according to different methods of treatment ,the patients′28‐day survival rates of these 2 groups were compared .Modified early goal‐directed therapy are divided into survival group (n=46) and non‐survival group (n=11) according to 28‐day prognosis .Acute physiology and chronic health evaluation Ⅱ (APACHEⅡ ) score ,sequential organ failure assessment (SOFA) ,multiple organ dysfunction syndrome (MODS) score and other relevant indicators of survival group and non‐survival group were compared .Results The 28‐day survival rate in modified early goal‐directed therapy group had increased approximately 18 .9% higher than that of the traditional early goal‐directed therapy group(P< 0 .05) .The APACH Ⅱ score ,SOFA score and MODS score in non‐survivors were significantly higher than those of survivors in modified EGDT group ,which were[(29 .36 ± 1 .57)d vs .(24 .30 ± 3 .27)d] ,[(13 .45 ± 0 .52)d vs .(12 .78 ± 1 .33)d] ,[(9 .00 ± 0 .00)d vs .(4 .04 ± 1 .94)d]separately .And vaso‐pressors time and mechanical ventilation time was significantly longer in non‐survivors than survivors(P<0 .05) .Conclusion Mod‐ified early goal directed therapy could improve 28‐day survival rate ,and it show s beneficial effects on outcome of critical patients w ith septic shock .