Analysis Of Fluid Balance In Ventilated Patients With Sever Pneumonia

ObjectiveTo investigate the mechanism and manifestations of fluid balance in mechanical ventilated patients with sever pneumonia.MethodPatients were observed continuously in a perspective study.64 invasive ventilated patients with sever pneumonia were enrolled,divided to two groups according to the fluid balance during seven days.A number of demographic and physiologic variables were extracted from the medical records.Past medical history,age,admission APACHEII and serum creatinine was analyzed as influencing factors.We monitored the fluid balance and studied the relationship between fluid balance and CPIS,PCT, adequate antibiotic therapy,successful weaning from ventilation and outcome.ResultsTwenty eight of thirty six patients who achieved a negative fluid balance during the first severn days of treatment survived,only six of twenty eighy patients who failed to achieve a negative fluid balance survived,P＜0.05.Significant differences were found in the numbers of malignant tumor,prior glucocorticoid treatment,adequate antibiotic therapy and weaning from ventilation between the two groups.CPIS of negative fluid balance group was respectively 7.49±1.13,5.97±1.00, 5.21±1.60,3.89±1.53 on D1,D3,D5,D7,and that of positive fluid balance group was respectively 7.61±1.10,7.67±0.86,7.87±1.40, 7.90±1.52.Significant difference was found in CPIS in the two groups, F=176.486,P＜0.05.Numbers of PCT＞2ng/ml of negative fluid balance group was respectively 32,12,5,4 on D1,D3,D5,D7,and that of positive fluid balance group was respectively 25,23,22,20.Significant difference was found in Numbers of PCT＞2ng/ml in the two groups, x~2=17.765,P＜0.05.ConclusionThe negative fluid balance achieved in the first 7 days of treatment suggests effective control of sepsis,and probably portends a good prognosis in invasive ventilated patients with severe pneumonia.