Clinical Application of Transabdominal Ultrasound Combined with PICCO in Septic Shock Fluid Resuscitation and Its Predictive Value for Survival Outcome

Ultrasound Med Biol. 2021 Nov;47(11):3196-3201. doi: 10.1016/j.ultrasmedbio.2021.07.023. Epub 2021 Aug 22.

Abstract

To investigate the clinical value of transabdominal ultrasound combined with pulse index continuous cardiac output (PICCO) in fluid resuscitation of septic shock patients, and to analyze the predictive value of survival outcomes, 68 patients with septic shock were randomly divided into the ultrasound + PICCO group and PICCO group. Compared with before treatment, blood lactic acid (BLA) was cleared, and central venous pressure (CVP) and oxygenation index were significantly increased in all patients. The oxygen binding index, central venous oxygen saturation (ScVO2), and CVP in the ultrasound + PICCO group were increased compared with the PICCO group, while BLA, mechanical ventilation time, total fluid resuscitation input and hospitalization were significantly reduced. The extravascular lung water index and shape change index were positively correlated with sequential organ failure assessment. The combination of extravascular lung water index and shape change index had higher clinical value than each alone in predicting the death of patients with septic shock. The combination of transabdominal ultrasound with PICCO is better at guiding fluid resuscitation in patients with septic shock and has a certain predictive value with respect to the survival outcome of septic shock patients.

Keywords: Fluid resuscitation; Pulse index continuous cardiac output (PICCO); Septic shock; Shape change index; Sonography; extravascular lung water index (EVLWI).

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiac Output
  • Extravascular Lung Water
  • Fluid Therapy
  • Humans
  • Oxygen Saturation
  • Shock, Septic* / diagnostic imaging
  • Shock, Septic* / therapy