NICOM In ICU Patients With Severe Heart Failure

ObjectiveTo observe the application of noninvasive cardiac output monitoring device?NICOM?in patients with severe heart failure in ICU.Methods60 patients with severe heart failure admitted to ICU of Tangshan GongRen Hospital from January 2018 to December 2018 were randomly divided into routine monitoring group?n=30?and NICOM monitoring group?n=30?.The routine monitoring group received routine treatment according to mean arterial pressure?MAP?,heart rate?HR?,urine volume,central venous pressure?CVP?,bedside ultrasound indexes:left ventricular ejection fraction?LVEF?,cardiac output?CO?,inferior vena cava width?IVC?.On the basis of routine monitoring,NICOM monitoring group combined with NICOM monitoring indicators,cardiac output?CO?,cardiac index?CI?,stroke output?SV?,peripheral vascular resistance?TPR?,peripheral vascular resistance index?TPRI?and thoracic fluid content?TFC?were treated.The hemodynamic parameters,laboratory parameters and bedside ultrasound results were recorded on admission,the first day,the third day and the fifth day after treatment.Results1 There were significant differences in MAP,HR,CVP,CO,CI,SV,TPR,TPRI,LVEF,P/F,SvO₂,GAP,NT-proBNP,Lac and TFC before and after admission?P<0.05?.There were significant differences in MAP,HR,CVP,CO,CI,SV,TPR,TPRI,LVEF,P/F,SvO₂,GAP,NT-proBNP,Lac and TFC between routine monitoring group and NICOM monitoring group before and after admission?P<0.05?.3 Comparing the monitoring indicators of the two groups:MAP,CO,CI,SV,LVEF,P/F,SVO₂ of the two groups showed a gradual increase trend,HR,CVP,TPR,TPRI,GAP,NT-proBNP,Lac showed a gradual decrease trend.The improvement of HR,CO,CI,TPRI,LVEF,P/F,SvO₂,GAP,NT-proBNP in NICOM monitoring group on the first day of treatment was significantly better than that in routine monitoring group?P<0.05?;the improvement of MAP,HR,CVP,CI,SV,LVEF,P/F,GAP,NT-proBNP in NICOM monitoring group on the third day of treatment was significantly better than that in routine monitoring group?P<0.05?.The HR,CVP,CO,CI,SV,TPR,TPRI,LVEF,P/F,SvO₂,GAP,NT-proBNP and TFC of the patients in the treatment group were significantly improved compared with those in the routine monitoring group?P<0.05?.There was no significant difference in time-group interaction among MAP,HR,CVP,CO,CI,TPR,TPRI,NT-proBNP,Lac and TFC?P>0.05?.There were statistical differences among SV,LVEF,P/F,SvO₂ and GAP?P<0.05?.Conclusion Continuous monitoring of hemodynamic parameters by NICOM can guide the treatment of ICU patients with severe heart failure,which can improve the hemodynamic status of patients more effectively,and has guiding significance for clinical practice.Figure3;Table20;Reference 177...