Analysis Of Hemodynamics For The Prognosis Of Septic Shock Patients With Fluid Resuscitation

Objective: Discussion the septic shock patients with early standard therapy impact on the prognosis of patients after fluid resuscitation hemodynamics, and related factors provide the basis for the clinical treatment of septic shock.Methods: Included in the First Affiliated Hospital of Xinjiang Medical University in January 2015 ~ December 2015 of ICU, by a total of 45 cases of patients after standard therapy fluid resuscitation, comparison of survival group difference variation of hemodynamic parameters between groups and death; by CVP, MAP and urine output are standard or not grouping three metrics to compare their impact on prognosis; according to one of the indicators of compliance or not the packet analyzed prognostic Factors.Using software SPSS17.0, count data using chi-square test, measurement data using t test or rank sum test, risk factors associated with the use of binary regression analysis, according to P<0.05 statistically different.Results:The distribution of the source of infection were pulmonary infection(57.8%),intestinal infection(13.3%),intracranial and urinary infection(6.7%),other infection(15.5%).Survival group and the basic characteristics of the two groups was no difference in the death group, APACHE II score and ICU MEWS difference was statistically significant and independent risk factor for; 0h, 6h vital signs, MAP was no significant difference between the two groups, 6h Lac difference between the two groups was statistically significant, blood lactate <4mmol / L reduced mortality. Total compliance or not packet groups, in addition to lactate levels(t=-2.48, P=0.02), other general features no significant difference(P>0.05). Single indicators of compliance or not with prognosis(P>0.05). CVP and fluid resuscitation volume related, 6h different CVP correspond to different levels of mortality, and with the CVP increased risk of death also increased. Totalfluid resuscitation groups of 6h difference was statistically significant(P=0.01), 6hCVP amount of fluid resuscitation with negative correlation coefficient of-0.436(P=0.003),6hCVP different levels corresponding to different mortality. Prognostic role of 0h MAP was bigger than 6h MAP(AUC respectively was 0.651,0.631).Conclusion: Vital signs of septic shock is not as predictive prognostic monitoring indicators; CVP, MAP and urine output are standard or one or three standard or not has nothing to do with the prognosis;MAP predict prognosis of septic shock; in the fluid resuscitation 6h CVP control 8-12 mmHg can reduce mortality; 6h within Lac reduce can reduce mortality.