Clinical Application Of PiCCO Monitoring In The Treatment Of Patients With Acute Kidney Injury In Early Stage Of Large Area Burn

Objective:To explore the effect of fluid resuscitation and kidney function on patients with acute kidney injury in early stage of large area burn under the guidance of PiCCO monitoring technology.Methods:A retrospective analysis of 45 patients with acute kidney injury in the early stage of large area burn from March 2014 to September 2018 in the Gansu Provincial People’s Hospital Burn Department.They were divided into PiCCO monitoring group and general monitoring group according to their use of PiCCO monitoring technique or not.There were 21 cases of PiCCO monitoring group and 24 cases of general monitoring group.The information we counted for the two groups of patients included general data,rehydration volume at the first 24 h and the second 24 h after burn,and urine volume at 24 h and 48 h after burn.We also counted lactic acid,serum creatinine,and cystatin C at admission,24 h,48 h,and 72 h after burn.Finally,all data are statistically analyzed.Results:(1)There was no statistical significance in comparison of general data between the two groups(P>0.05).(2)The volume of fluid rehydration in the first 24 hours after burn in PiCCO group was more than that in general group,and the difference was statistically significant(P<0.01).The volume of fluid rehydration in the second 24 hours after burn in PiCCO group was less than that in general group,and the difference was statistically significant(P<0.01).There was no statistical significance in comparison of the total fluid volume between the two groups at 48 hours after burn.There was no statistical significance in comparison of urine volume between the two groups at 24 h and 48 h after burn(P>0.05).(3)There was no statistical significance in comparison of lactic acid between the two groups at admission(P>0.05).At 24 h,48h,72 h after burn,the lactic acid in both groups was less than that on admission,and the difference was statistically significant(P<0.01);the lactic acid in the PiCCO group was lower than that in the general group at 24 h,48h,and 72 h after burn,and the difference was statistically significant(P<0.01).(4)There was no statistical significance in comparison of serum creatinine and cystatin C between the two groups at admission(P>0.05).At 24 h after burn,serum creatinine and cystatin C in both groups was more than that on admission,and the difference was statistically significant(P<0.01);the serum creatinine and cystatin C in the PiCCO group was lower than that in the general group at 24 h,48h,and 72 h after burn,and the difference was statistically significant(P<0.01).Conclusion:In the early stage of large area burn patients with acute kidney injury,the liquid resuscitation effect under the guidance of PiCCO monitoring technology is better than the general monitoring method and can help to reduce kidney damage.