关键词: 休克, 脓毒性, 脉搏指示连续心排血量, 预后

Abstract: Objective To explore the application of pulse indicator continuous cardiac output (PICCO) to monitor the impact of different time points to achieve resuscitation goals on the prognosis of septic shock patients. 
Methods In total, 56 patients with septic shock treated in the intensive care unit (ICU) were selected as the research subjects. According to the time points when the intrathoracic blood volume index (ITBVI) reached 850-1 000 mL/m2, they were divided into the early standard reaching group (0-6 h, n=31) and the late standard reaching group (7-12 h, n=25). Oxygenation index, lactate, infection-related sequential organ failure assessment (SOFA), liver and kidney function indicators ［total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum creatinine (SCr)］ of two groups at 0 h, 6 h, 12 h, 24 h, and 48 h, and the length ofICU stay, mechanical ventilation time, and 7-day and 28-d aymortality rate in the two groups were compared. 
Results There was no statistically significant difference in the interaction between groups, time points, and time points between groups with respect to the oxygenation index between the two groups (P＞0.05). The lactate concentration in both groups showed a gradually decreasing trend, and the lactate concentration in the early standard reaching group was significantly lower than that in the late standard reaching group; there were statistically significant differences in the interaction between groups, time points, and time points between groups (P＜0.05). The SOFA scores of both groups showed a gradually decreasing trend, and the lactate concentration in the early standard reaching group was significantly lower than that in the late standard reaching group; there were statistically significant differences in the interaction between groups, time points, and time points between groups (P＜0.05). The levels of SCr, ALT, AST, and TBIL in two groups showed a gradually decreasing trend, and the lactate concentration in the early standard reaching group was significantly higher than that in the late standard reaching group; the differences in interaction between groups, time points, and time points between groups were statistically significant (P＜0.05). There was no significant difference in length of ICU stay, mechanical ventilation time, and 7-day mortality rate between the two groups (P＞0.05), while the 28-day mortality rate of the early standard reaching group was significantly lower than that of the late standard reaching group; the difference was statistically significant (P＜0.05). 
Conclusion Under the guidance of PICCO monitoring, implementing fluid resuscitation treatment for septic shock patients can improve patient prognosis in both early and late standard reaching groups. However, the early standard reaching group can significantly decrease SOFA scores and reduce 28-day mortality rate compared with the late standard reaching group. 

Key words: shock, septic, pulse indicator continuous cardiac output, prognosis