Xin yixue (Aug 2022)

Clinical application value of PiCCO in volume management of severe abdominal surgery patients

  • Lyu Wen, Zhong Yuanbo, Xu Jianzhong, Xu Sihai, Shan Aijun, Wang Jin

DOI
https://doi.org/10.3969/j.issn.0253-9802.2022.08.007
Journal volume & issue
Vol. 53, no. 8
pp. 570 – 574

Abstract

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Objective To investigate the clinical application value of pulse indicated continuous cardiac output （PiCCO） in volume management of patients undergoing severe abdominal surgery. Methods Sixty patients undergoing severe abdominal surgery were recruited and divided into the study group （n = 30） and control group （n = 30） by random number table method. All patients received symptomatic treatment. Patients in the control group received routine monitoring to guide fluid infusion, and their counterparts in the study group were given with PiCCO monitoring to guide fluid infusion. The total volume of infusion, urine volume, duration of mechanical ventilation, mortality rate and length of hospital stay were compared between two groups. Heart rate （HR）, mean arterial pressure （MAP）, oxygenation index （OI）, central venous oxygen saturation （ScvO2）, lactic acid （LAC）, Acute Physiology and Chronic Health Evaluation II （APACHEⅡ） before treatment （T0）, after 12 h （T1） and 24 h treatment （T2） were compared between two groups. The incidence of adverse events was also compared between two groups. Results The total volume of infusion, length of hospital stay and mortality rate in the study group were significantly lower than those in the control group （all P < 0.05）. In each group, the orders of HR and OI were T0 > T1 > T2, that of MAP was T0 < T1 < T2 （all P < 0.05）. The orders of LAC level and APACHE II score were T0 > T1 > T2, and that of ScvO2 level was T0 < T1 < T2 （all P < 0.05）, respectively. In the study group, LAC level and APACHE II score at T1 and T2 were significantly lower, whereas ScvO2 at T1 and T2 was significantly higher than those in the control group （all P < 0.05）. The total incidence of adverse events in the study group was 10%, significantly lower than 33% in the control group （P < 0.05）. Conclusion PiCCO monitoring can better guide the volume management of patients undergoing severe abdominal surgery, improve clinical prognosis and yield high clinical value.

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