No abstract

No abstract

Purpose: Invasive hemodynamics monitor directed fluids resuscitation remains misgiving issues. This study aims to explore the predictive value of the PiCCO system (pulse indicator continuous cardiac output device) and blood gas parameters on the early prognosis of patients with sepsis.Methods: 42 patients with sepsis were included from January 2013 to January 2015. All patients were stratified into survivor group (n=29) and nonsurvivor group (n=13) based on seven day-mortality. The PiCCO and blood gas parameters at enrollment and 24 hours were compared between two groups. The predictive performance of these parameters was distinguished with Area Under the Receiver Operating Characteristic Curve (AUC). Results: At 24 hours after enrollment, the HR (97.27±22.07 vs. 120.20±20.56), extravascular lung water index (EVLWI) (7.32±2.96 vs. 15.9±11.2), and lactic acid (Lac) (1.62±0.92 vs. 6.33±5.83) level were significantly lower in survivor group (P < 0.05), whereas the cardiac index (CI) (3.67±0.85 vs. 2.98±0.73) and PaO2/FiO2 (242.8±89.68 vs.136.07±78.01) increased significantly. Meanwhile PaO2/FiO2 was negatively correlated with EVLWI (r= -0.673, P < 0.01). The AUC of the combination of Lac with PaO2/FiO2, HR, EVLWI, pulmonary vascular permeability index (PVPI) and Lac at 24 hours were 0.853, 0.739, 0.776, 0.764, and 0.794.Conclusions: The PiCCO and blood gas parameters exhibit superior predictive capability for early prognosis in patients with sepsis, and the combination Lac with PaO2/FiO2 was noninferior under the circumstance of unavailability with PiCCO.