Laboratory analysis on influence of different monitoring modes on related biochemical indicators of early fluid resuscitation in severe sepsis / 国际检验医学杂志

ABSTRACT

Objective To compare the early fluid resuscitation effect of transpulmonary thermodilution (PICCO) monitoring combined with the passive leg raising (PLR) test and central venous pressure(CVP) mo-nitoring in severe sepsis .Methods Sixty patients with severe sepsis admitted in this hospital from January to December 2016 were selected and divided into the treatment group (n=28) and control group(n=32) accord-ing to the random number table method .The treatment group adopted PICCO monitoring combined with PLR ,while the control group adopted CVP monitoring .The changes of plasma natriuretic peptide (BNP) and blood lactic acid(LAC) levels at 6 ,24 ,48 ,72 h in two groups ,time of vasoactive drugs withdrawn ,mechanical ventilation time ,ICU stay length ,and occurrence situation of multiple organ dysfunction syndrome (MODS) and death were compared between the two groups .Results The plasma BNP levels at 24 ,48 ,72 h in the treat-ment group were lower than those in the control group at the same period ,the difference was statistically sig-nificant(P<0 .05);The plasma LAC levels at 24 ,48 ,72 h in the treatment group were lower than those in the control group at the same periods ,the difference was statistically significant (P<0 .05);The vasoactive drug withdrawal time in the treatment group was faster than that in the control group ,the mechanical ventilation time was shorter than that in the control group ,and the ICU stay time was shorter than that in the control group ,the difference was statistically significant (P<0 .05);The occurrence rates of MODS and death had no statistical difference between the two groups (P>0 .05) .Conclusion The PICCO monitoring combined with PLR in severe sepsis has better early fluid resuscitation curative effect than the CVP monitoring and has im-portant study significance .