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Effect of focused cardiopulmonary ultrasonography on clinical outcome of septic shock: a randomized study
Authors:Li Li  Yuhang Ai  Xiaoting Wang  Hongmin Zhang  Xinhua Ma  Li Huang  Meilin Ai  Qianyi Peng  Lina Zhang
Affiliation:1.Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, China; 2.Department of Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China
Abstract:ObjectiveTo investigate the effect of focused ultrasonography on clinical outcomes of septic shock.MethodsPatients with septic shock were randomized into an integrated cardiopulmonary ultrasonography (ICUS) group and conventional (CON) group. Within 1 hour of admission, the ICUS group underwent ICUS examination for hemodynamic decision-making, while the CON group received standard treatment. The primary endpoint was 28-day mortality after admission. The secondary endpoints were cumulative fluid administration in the first 6, 24, and 72 hours; use of vasoactive drugs; lactate clearance; duration of ventilation; and ICU stay.ResultsNinety-four qualified patients were enrolled (ICUS group, 49; CON group, 45). ICUS showed no significant effect on 28-day mortality. Within the initial 6 hours, the ICUS group tended to have a higher fluid balance and fluid intake than the CON group. The duration of vasopressor support was shorter in the ICUS group. There were no differences in the cumulative fluid infusion within 24 or 72 hours, lactate clearance, ICU stay, or duration of ventilation.ConclusionsThe initially focused ICUS did not affect the clinical outcomes of septic shock, but it tended to be associated with a higher fluid balance within the initial 6 hours and shorter duration of vasopressor support.
Keywords:Focused ultrasonography   early goal-directed therapy   severe sepsis   septic shock   hemodynamic monitoring   clinical outcome
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