Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, China.
Department of Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China.
J Int Med Res. 2021 May;49(5):3000605211013176. doi: 10.1177/03000605211013176.
To investigate the effect of focused ultrasonography on clinical outcomes of septic shock.
Patients 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.
Ninety-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.
The 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.
探讨聚焦超声对感染性休克临床结局的影响。
将感染性休克患者随机分为整合心肺超声（ICUS）组和常规（CON）组。入院后 1 小时内，ICUS 组进行 ICUS 检查以进行血流动力学决策，而 CON 组接受标准治疗。主要终点为入院后 28 天死亡率。次要终点为前 6、24 和 72 小时的累积液体输注量；血管活性药物的使用；乳酸清除率；通气时间；和 ICU 住院时间。
共纳入 94 例合格患者（ICUS 组 49 例，CON 组 45 例）。ICUS 对 28 天死亡率没有显著影响。在最初的 6 小时内，ICUS 组的液体平衡和液体摄入量均高于 CON 组。ICUS 组的血管加压支持持续时间较短。在 24 或 72 小时内，累积液体输注量、乳酸清除率、ICU 住院时间或通气时间无差异。
最初的集中 ICUS 并未影响感染性休克的临床结局，但在最初 6 小时内可能与更高的液体平衡和更短的血管加压支持持续时间相关。
