Comparative Study Of Critical Care Ultrasound And PiCCO In Guiding Fluid Resuscitation Of Sepsis

Objective: Objective to investigate the effect of Critical Care ultrasound and PiCCO in guiding fluid resuscitation of sepsis.Methods: 121 cases of sepsis diagnosed in our hospital from July 2018 to December2020 were selected,according to the different methods of guiding fluid resuscitation,the experimental group(n = 62)was guided by critical care ultrasound,and the control group(n =59)was guided by pulse indicator continuous cardiac output(PiCCO),The heart rate,mean arterial pressure,systolic pressure,diastolic pressure,central venous pressure and urine volume of the experimental group and the control group were compared at 1 h,3 h,6 h,24 h and 72 h during the treatment;The number of people in the experimental group and the control group who reached the standard of fluid resuscitation at 1 h,3 h,6 h and 24 h during the treatment was compared;The number of patients with pulmonary edema in the experimental group and the control group at 1 h,3 h,6 h,24 h and 72 h during the treatment was compared.Results:(1)There was no significant difference in gender,age,Apache Ⅱ score and the number of vasoactive drug users between critical care ultrasound group and PiCCO group(P > 0.05).(2)The heart rate of 1 h,3 h,6 h,24 h and 72 h in PiCCO group was higher than that in critical care ultrasound group(all P < 0.05).(3)There was no significant difference in mean arterial pressure at 1 h,3 h and 24 h between the two groups(all P > 0.05).The mean arterial pressure at 6 h in PiCCO group was higher than that in critical care ultrasound group,and the mean arterial pressure at 72 h in critical care ultrasound group was higher than that in PiCCO group,with significant difference between the two groups(P < 0.05).(4)The systolic blood pressure at 3 h and 24 h in critical care ultrasound group was higher than that in PiCCO group,and the difference was statistically significant(P < 0.05).There was no significant difference in systolic blood pressure at 1 h,6 h and 72 h between the two groups(all P > 0.05).(5)The diastolic blood pressure at 3 h and 6 h in PiCCO group was higher than that in critical care ultrasound group,and the diastolic blood pressure at 72 h in critical care ultrasound group was higher than that in PiCCO group,and the difference was statistically significant(P< 0.05).There was no significant difference in diastolic blood pressure at 1 h and 24 h between the two groups(all P > 0.05).(6)The central venous pressure at 1 h and 3 h in PiCCO group was higher than that in critical care ultrasound group,and the central venous pressure at 24 h in critical care ultrasound group was higher than that in PiCCO group,with significant difference between the two groups(all P < 0.05),but there was no significant difference at 6 h and 72 h between the two groups(all P > 0.05).(7)The urine volume at 1 h,3 h,6 h,24 h and 72 h in critical care ultrasound group was more than that in PiCCO group,and the difference was statistically significant(all P < 0.05).(8)There was no significant difference in the number of patients with fluid resuscitation between critical care ultrasound group and PiCCO group(P > 0.05).(9)There was no significant difference in the number of patients with pulmonary edema at 1 h and 3 h between the two groups(P > 0.05).The number of patients with pulmonary edema at 6h,24 h and 72 h in PiCCO group was more than that in severe ultrasound group,and the difference was statistically significant(P < 0.05).Conclusion:(1)Compared with patients with severe sepsis fluid resuscitation guided by critical care ultrasound,patients with PiCCO guidance had higher heart rate;(2)Compared with the number of patients with sepsis fluid resuscitation under the guidance of PiCCO,there was no difference in the results of using critical care ultrasound guidance,and the blood pressure of the two groups could be controlled in the target range;(3)Compared with PiCCO,there is no difference in the results of using critical care ultrasound guidance in patients with sepsis fluid resuscitation,and the central venous pressure can be controlled in the normal range;(4)Compared with PiCCO,critical care ultrasound guided fluid resuscitation patients had more urine volume and less pulmonary edema.