PiCCO監(jiān)測下的液體管理對老年急性呼吸窘迫綜合征患者預后的意義
發(fā)布時間：2018-10-05 18:04
【摘要】：目的探討脈波輪廓溫度稀釋連續(xù)心排量監(jiān)測技術(shù)(Pi CCO)血流動力學監(jiān)測對急性呼吸窘迫綜合征(ARDS)患者液體管理的意義。方法因ARDS收入院、治療時間超過1 w的患者46例,入院后隨機分為常規(guī)液體管理組及Pi CCO液體管理組。入院后所有患者首先經(jīng)驗性應用抗生素,并根據(jù)痰培養(yǎng)及血培養(yǎng)等病原學檢查調(diào)整抗生素應用。根據(jù)患者氧合、動脈血氣進行無創(chuàng)或有創(chuàng)呼吸機輔助通氣治療。常規(guī)液體管理組監(jiān)測患者血壓、心率、中心靜脈壓(CVP)等,依據(jù)心率、血壓、CVP等指標進行液體管理。Pi CCO液體管理每日進行2次Pi CCO監(jiān)測,根據(jù)Pi CCO數(shù)據(jù)進行液體管理。檢測血漿白細胞介素(IL)-1,IL-10,腫瘤壞死因子(TNF)-α等炎癥因子水平,計算每位患者序貫器官衰竭估計(SOFA)評分、機械通氣時間、重癥監(jiān)護室(ICU)住院時間等,3個月統(tǒng)計患者病死率。結(jié)果 Pi CCO液體管理組患者累計液體入量較常規(guī)液體管理組明顯減少,炎癥因子水平降低,病死率降低(均P0.05)。結(jié)論 Pi CCO血流動力學監(jiān)測可以減少ARDS患者的液體正平衡,減輕炎癥反應,降低病死率。
[Abstract]:Objective to investigate the significance of (Pi CCO) hemodynamic monitoring in the management of fluid in patients with acute respiratory distress syndrome (ARDS) by pulse temperature dilution continuous cardiac output monitoring. Methods 46 patients with ARDS admitted to hospital for more than 1 week were randomly divided into routine fluid management group and Pi CCO fluid management group. After admission, all patients were treated with antibiotics empirically, and the antibiotics were adjusted according to sputum culture and blood culture. Non-invasive or invasive ventilator-assisted ventilation was performed according to oxygenation and arterial blood gas. The blood pressure, heart rate and central venous pressure (CVP) were monitored in the routine fluid management group. According to the indexes of heart rate and blood pressure, Pi CCO was monitored twice a day by the liquid management of Pi CCO, and the liquid was managed according to the Pi CCO data. The levels of IL-10, (TNF)-偽 and IL-10 in plasma were measured. The (SOFA) score, the time of mechanical ventilation, the hospitalization time of (ICU) in intensive care unit were calculated for each patient. The mortality rate was calculated at 3 months. Results the accumulative fluid volume in Pi CCO liquid management group was significantly lower than that in the conventional liquid management group, the level of inflammatory factors and the mortality were decreased (P0.05). Conclusion Pi CCO hemodynamic monitoring can reduce the positive liquid balance, reduce inflammatory reaction and reduce mortality in patients with ARDS.
【作者單位】： 深圳市人民醫(yī)院急診科;
【基金】：深圳市科技計劃項目(20140416122812041)
【分類號】：R563.8
[Abstract]:Objective to investigate the significance of (Pi CCO) hemodynamic monitoring in the management of fluid in patients with acute respiratory distress syndrome (ARDS) by pulse temperature dilution continuous cardiac output monitoring. Methods 46 patients with ARDS admitted to hospital for more than 1 week were randomly divided into routine fluid management group and Pi CCO fluid management group. After admission, all patients were treated with antibiotics empirically, and the antibiotics were adjusted according to sputum culture and blood culture. Non-invasive or invasive ventilator-assisted ventilation was performed according to oxygenation and arterial blood gas. The blood pressure, heart rate and central venous pressure (CVP) were monitored in the routine fluid management group. According to the indexes of heart rate and blood pressure, Pi CCO was monitored twice a day by the liquid management of Pi CCO, and the liquid was managed according to the Pi CCO data. The levels of IL-10, (TNF)-偽 and IL-10 in plasma were measured. The (SOFA) score, the time of mechanical ventilation, the hospitalization time of (ICU) in intensive care unit were calculated for each patient. The mortality rate was calculated at 3 months. Results the accumulative fluid volume in Pi CCO liquid management group was significantly lower than that in the conventional liquid management group, the level of inflammatory factors and the mortality were decreased (P0.05). Conclusion Pi CCO hemodynamic monitoring can reduce the positive liquid balance, reduce inflammatory reaction and reduce mortality in patients with ARDS.
【作者單位】： 深圳市人民醫(yī)院急診科;
【基金】：深圳市科技計劃項目(20140416122812041)
【分類號】：R563.8
【相似文獻】
相關(guān)期刊論文 前3條
1 滕s，
本文編號：2254345
本文鏈接：http://sikaile.net/yixuelunwen/huxijib/2254345.html
最近更新
教材專著
