Yuanbo Z, Jin W, Fei S, Liangong L, Xunfa L, Shihai X, Aijun S. ICU management based on PiCCO parameters reduces duration of mechanical ventilation and ICU length of stay in patients with severe thoracic trauma and acute respiratory distress syndrome.
Ann Intensive Care 2016;
6:113. [PMID:
27873292 PMCID:
PMC5118373 DOI:
10.1186/s13613-016-0217-6]
[Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 11/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND
This study aimed to assess whether a management algorithm using data obtained with a PiCCO system can improve clinical outcomes in critically ill patients with acute respiratory distress syndrome (ARDS).
RESULTS
The PaO2/FiO2 ratio increased over time in both groups, with a sharper increase in the PiCCO group. There was no difference in 28-day mortality (3.2 vs. 3.6%, P = 0.841). Days on mechanical ventilation (3 vs. 5 days, P = 0.002) and ICU length of stay (6 vs. 11 days, P = 0.004) were significantly lower in the PiCCO group than in the CVP group. Treatment costs were lower in the PiCCO group than in the CVP group. Multivariate logistic regression model showed that the monitoring method (PiCCO vs. CVP) was independently associated with the length of ICU stay [odds ratio (OR) 3.16, 95% confidence interval (95% CI) 1.55-6.63, P = 0.001], as well as shock (OR 3.41, 95% CI 1.74-6.44, P = 0.002), shock and ARDS (OR 3.46, 95% CI 1.79-6.87, P = 0.002), and APACHE II score (OR 1.17, 95% CI 1.02-1.86, P = 0.014).
CONCLUSIONS
This study investigated the usefulness of the PiCCO system in improving outcomes for patient with severe thoracic trauma and ARDS and provided new evidence for fluid management in critical care settings.
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