PiCCO技术在重症医学中的应用

The application of PiCCO in intensive medical

目的探讨脉波轮廓温度稀释连续心排量测量仪（pulse inducator continous cadiac output,PiCCO）技术在重症医学科中的应用效果。方法选取2014年10月~2015年6月我院ICU收治的21例多发创伤患者,使用PiCCO监测技术指导液体复苏。记录复苏前、复苏后6 h、复苏后12 h的PiCCO容量性指标的变化,容量性指标：每搏排血量变异度（SVV）、血管外肺水指数（EVLWI）、胸腔内血容量指数（ITBVI）、全心舒张末容积指数（GEDVI）以及观察心率（HR）、平均动脉压（MAP）、中心静脉压（CVP）、心脏指数（CI）的变化,并应用统计学进行分析。结果复苏后MAP、CI、GEDVI、ITBVI和CVP的值较复苏前均有增高,差异有统计学意义（P〈0.05）;复苏后SVV的值较复苏前下降,差异有统计学意义（P〈0.05）;复苏后EVLWI的值较复苏前有上升,差异无统计学意义（P〉0.05）。结论根据PiCCO监测指标指导救治和纠正休克,短期临床效果满意,PiCCO技术在重症医学科中的应用是安全、可靠的,应为必备仪器之一。

Objective To explore the effect of pulse inducator continous cadiac output（PiCCO） technology in the application of intensive care unit（ICU）.Methods 21 patients of multiple traumatic from October 2014 to June 2015 in ICU were selected and used PiCCO monitoring technology to guid resuscitation.The change of the capacity index of PiCCO before and after resuscitation（6 hours and 12 hours） were recorded.The capacity index：stroke volume variation（SVV）,extravascular lung water index（EVLWI）,intrathoracis blood volume index（ITBVI）,global end diastolic volume index（GEDVI）.Observe the change of heart rate（HR）,mean arterial pressure（MAP）,central venous pressure（CVP）,cardiac index（CI）,and after that an analyzation by using statistics was given.Results Compared with the score of MAP,CITBVI,GEDVI and CVP before resuscitation increased significantly after resuscitation（P0.05）.Compared with the score of SVV before resuscitation decreased significantly after resuscitation（P0.05）.The score of EVLWI before resuscitation increased,However,there was no obvious difference（P0.05）.Conclusion Accoding the PiCCO monitoring index to guide treatment and cure shock has satisfactory effect in short term.PiCCO technology is the most secure and reliable,and should be the one of most needed instrument in ICU.