NGHIÊN CỨU SỰ BIẾN ĐỔI CỦA MỘT SỐ CHỈ SỐ HUYẾT ĐỘNG ĐO BẰNG PHƯƠNG PHÁP PICCO TRONG ĐIỀU TRỊ BỆNH NHÂN SỐC NHIỄM KHUẨN NGOẠI KHOA TẠI BỆNH VIỆN QUÂN Y 175

Abstract

Objective: To evaluate the changes in selected hemodynamic parameters measured by the PiCCO system in the management of patients with surgical septic shock. Subjects and Methods: This was a descriptive cross-sectional study with longitudinal follow-up and pre-post comparison, conducted on 39 patients diagnosed with septic shock treated at the Department of Surgical Intensive Care, 175 Military Hospital, from January 2023 to December 2024. Results: Among the 39 patients with surgical septic shock, the mortality rate was 35.9%. There were no statistically significant differences in age, sex, or primary source of infection between the mortality and survival groups (p > 0.05). However, CRP, creatinine, and PCT levels, as well as APACHE II and SOFA scores, were significantly higher in the mortality group compared to the survival group (p < 0.05). Following fluid resuscitation, both mean arterial pressure (MAP) and cardiac index (CI) showed statistically significant increases after each of the three resuscitation phases (p < 0.01 to p < 0.001). The extravascular lung water index (EVLWI) increased significantly only after the first fluid resuscitation (p < 0.05) and showed no significant changes after the second and third interventions (p > 0.05). Conclusion: CRP, creatinine, PCT levels, along with APACHE II and SOFA scores, were associated with mortality in surgical septic shock patients. Fluid resuscitation led to significant improvements in key hemodynamic parameters, particularly MAP and CI, across the resuscitation phases.