[The therapeutic effects of fluid resuscitation in severe sepsis and septic shock].
OBJECTIVE
To evaluate the therapeutic effect of fluid resuscitation on severe sepsis and septic shock.


METHODS
Twenty patients with severe sepsis and septic shock were given fluid resuscitation and got the following parameters in the ranges as follow: central venous pressure (CVP) 8 - 12 mm Hg (for ventilation patient: 12 - 15 mm Hg), mean artery pressure (MAP) 65 - 90 mm Hg, mixed venous oxygen saturation (SmvO(2)) > 70%. Hemodynamics, tissue perfusion and vascular endothelial cell function were measured and compared before and after fluid resuscitation.


RESULTS
Pulmonary arterial wedge pressure (PAWP), cardiac index (CI), left ventricular stroke work index (LVSWI) and systemic vascular resistance index (SVRI) increased significantly after reached the goal of fluid resuscitation (P < 0.01) whereas pulmonary vascular resistance index (PVRI), lactate level in arterial blood and gastric-to-arterial carbon dioxide partial pressure gap (Pg-aCO(2)) decreased significantly (P < 0.01), and the serum levels of endothelin (ET) and von Willebrand factor (vWF) were also decreased significantly after fluid resuscitation (P < 0.05).


CONCLUSIONS
Early goal-directed fluid resuscitation can improve hemodynamics, tissue perfusion and alleviate vascular endothelial cell injury in patients with severe sepsis and septic shock, it is an effective therapy for these patients.
Su
Qun
Q
Intensive Care Unit, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
Wu
Li-feng
LF
Fang
Qiang
Q
Yan
Jing
J
D001784:Blood Gas Analysis; D001794:Blood Pressure; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012151:Resuscitation / Q000379:methods*; D018805:Sepsis / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D012772:Shock, Septic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome