Zhonghua wei zhong bing ji jiu yi xue
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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue · Jan 2014
Randomized Controlled Trial[Clinical studies of surviving sepsis bundles according to PiCCO on septic shock patients].
To explore the effect of early goal-directed therapy (EGDT) according to pulse indicated continuous cardiac output (PiCCO) on septic shock patients. ⋯ Modified surviving sepsis bundle treatment according PiCCO can reduce the severity of disease in patients with septic shock, can make more accurately guide fluid resuscitation, and can reduce lung water and duration of mechanical ventilation and ICU stay. It has great clinical significance.
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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue · Jan 2014
Randomized Controlled Trial[The significance of lactic acid in early diagnosis and goal-directed therapy of septic shock patients].
To investigate the application of lactic acid in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. ⋯ By blood lactic acid monitoring, inadequacy of organization perfusion i.e. septic shock can be found in the early stage, thus early intervention can be performed and improve resuscitation result and reduce the mortality of septic shock patients. Blood lactic acid ≥ 4 mmol/L can be used as one of the criteria for the diagnosis of septic shock, and 6-hour blood lactic acid < 2 mmol/L as a goal to guide shock treatment with obvious prognosis improvement.
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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue · Jan 2014
[Change of platelet parameters in septic shock patients].
To observe the changes in platelet parameters including platelet volume distribution width (PDW), platelet crit (PCT) and platelet large cell ratio (PLCR) in patients with septic shock, and to approach its predictive effect on prognosis to obtain the indexes predicting the prognosis quickly and conveniently. ⋯ Different change trends of platelet parameters can be seen between the non-survivors and survivors of septic shock patients. If PDW, PLCR and MPV show increased trend while PLT and PCT show decreased trend, a poor prognosis maybe indicated. MPV may be most useful in prognosis forecast because of its biggest AUC.
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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue · Jan 2014
[Combination of Weighted index of comorbidities and sepsis-related organ failure assessment score in death risk evaluation of septic patients].
To predict the risk of 28- day mortality on septic patients in intensive care unit (ICU) with the combination of the Weighted index of comorbidities (WIC) and sepsis-related organ failure assessment (SOFA) score. ⋯ The sensitivity of 28-day prognosis 28-day prognosis by WIC score was improved greatly with the combination of SOFA score and age score.
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The present review concluded remarkable globe clinical achievements in the field of critical care medicine during 2013. Briefly, new international sepsis management guideline, high frequency oscillatory ventilation, hydroxyethyl starch, immune-nutritional therapy, fecal transplantation and infection controlling became the highlighting topics. Additionally, it is also worthy to note the apparent disparity in the results between meta-analyses suggesting a treatment advantage and following large-scale randomized trials that have failed to detect such differences in treatment outcomes. Nonetheless, we still expect the emerging of ongoing investigations may provide clarity in these area..