The effect of early external jugular vein access for fluid resuscitation on prognosis of sepsis patients / 中华急诊医学杂志

ABSTRACT

Objective To evaluate the effect of fluid resuscitation with early external jugular vein access on prognosis of sepsis patients.Methods One hundred and twenty patients with sepsis,admitted to emergency intensive care unit (EICU) and the general intensive care units (ICU) were randomly divided into two groups,external jugular vein group (n=60) and deep-vein group (e.g.internal jugular vein,subclavian vein,femoral vein,n=60).The time elapsed from admission to initial application of norepinephrine,the time required for getting the early goal directed therapy (EGDT) after standard procedure,the length of time needed for subsequent use of vasoactive agents during the entire course of resuscitation serum lactate level at3 h and 6 h after resuscitation,lactate clearance rate,SOFA scores were documented.The mortality rates of 14 days and 28 days were observed after treatment.Results Compared with deep vein access,the time elapsed from admission to the initial application of norepinephrine and the time required for getting EGDT were significantly shortened [(20.78±5.03) vs.(6.12±2.58),P＜0.01;(6.15±2.03)vs.(5.35±2.21),P＜0.05],and the serum level of lactate was significantly decreased[(6.88±1.71)vs.(6.28±1.51),P＜0.05] at 3 h after resuscitation,and lactate clearance rate in percentage was significantly increased at 3 h after resuscitation,and SOFA at 6 h was decreased[(25.8±9.2) vs.(31.2±13.3),P＜0.05],and SOFA at 6 h was distinctly reduced [(5.78±1.19) vs.(5.38±0.96),P＜0.05],and.the mortality rates of 14 days decreased significantly in the external jugular vein group(33.3％ vs.16.7％,P＜0.05).Conclusions Early external jugular vein access can more significantly save time,improve the effect of fluid resuscitation,promote recovery of important organ.It is helpful for improving prognosis in sepsis patients.