PiCCO监测在伴有中重度低钠血症休克患者进行容量复苏中的意义

[目的]探讨伴有中重度低钠血症的休克患者脉搏指数连续心输出量(PiCCO)监测的血流动力学特点.[方法]对19例伴有中重度低钠血症的休克患者的临床资料进行回顾性分析,根据预后分为存活组11例、死亡组8例,比较PiCCO连续监测记录每例置管期间的血流动力学参数,记录每例置管期间每日液体平衡(W),分析PiCCO监测的血流...

Significance of PiCCO Monitoring in Assessing the Volume Status of Shock Patients with Moderate to Severe Hyponatremia

[Objective] To explore the hemodynamic characteristics of pulse-indicated continuous cardiac output（PiCCO） monitoring for shock patients with moderate to severe hyponatremia. [Methods] The clinical data of shock patients with moderate to severe hyponatremia were analyzed retrospectively. According to the prognosis, all patients were divided into survival group（ n =11） and death group（ n =8）. PiCCO continuous monitoring was used to record the hemodynamic parameters and daily fluid balance volume（W） of every pa tients during intubation. The hemodynamic characteristics monitored by PiCCO and the risk factors influencing the prognosis of the patients were analyzed. [Results] When intubation, most of the hemodynamic types of the patients in two groups were the type of low cardiac output and high vascular resistance, and the extravascular lung water index（EVLWI） was high. During intubation, the W was significantly correlated with lhe change of EVLWI（△EVLWI）. and global end-diastolic volume index（△GEDI）. On the third day of intubation, EVLWl in death group was significantly higher than that in survival group（ P〈0.01）. [Conclusion] The （GEDI moni tored by PiCCO is more suitable for assessing the volume status of shock patients with moderate to severe hyponatremia than central venous pressure（CVP）. The dynamic change of EVLWI is an independent prognostic factor for shock patients with moderate to severe hyponatremia.