title: Global end-diastolic volume index vs CVP goal-directed fluid resuscitation for COPD patients with septic shock: a randomized controlled trial.
abstract: OBJECTIVE
  This study aimed to investigate the clinical effects of early goal-directed therapy according to the global end-diastolic volume index (GEDI) on chronic obstructive pulmonary disease (COPD) patients with septic shock.
  
  
  METHODS
  A total of 71 COPD patients with septic shock were randomly assigned to 2 groups. In the control group (n = 37), fluid resuscitation was performed based on the central venous pressure. In the study group (n = 34), fluid resuscitation was performed until GEDI reached 800 mL/m2. The following indices were observed for the 2 groups: 6- and 24-hour fluid volumes, norepinephrine dosage, 24-hour blood lactate clearance rate, duration of mechanical ventilation, intensive care unit (ICU) length of stay, ICU mortality, and 90-day survival rate.
  
  
  RESULTS
  At both 6- and 24-hour measurements, the fluid volume was lower and norepinephrine dosage was higher in the control group than in the study group (P < .05). The blood lactate clearance rate was lower, the duration of mechanical ventilation was longer, and the length of stay in the ICU was longer in the control group than in the study group (P < .05). No significant difference in mortality or 90-day survival rate was found between the 2 groups.
  
  
  CONCLUSIONS
  The GEDI goal-directed fluid resuscitation shows better clinical effects than that shown by central venous pressure for COPD patients with septic shock; however, it cannot reduce the mortality rate.
authors: Department of Intensive Care Unit, Northern Jiangsu People's Hospital, Yangzhou 225000, Jiangsu, China.
authors: Jiangquan
authors: J
authors: Yu
authors: Department of Intensive Care Unit, Northern Jiangsu People's Hospital, Yangzhou 225000, Jiangsu, China. Electronic address: 18051060659@163.com.
authors: Ruiqiang
authors: R
authors: Zheng
authors: Department of Intensive Care Unit, Northern Jiangsu People's Hospital, Yangzhou 225000, Jiangsu, China.
authors: Hua
authors: H
authors: Lin
authors: Department of Intensive Care Unit, Northern Jiangsu People's Hospital, Yangzhou 225000, Jiangsu, China.
authors: Qihong
authors: Q
authors: Chen
authors: Department of Intensive Care Unit, Northern Jiangsu People's Hospital, Yangzhou 225000, Jiangsu, China.
authors: Jun
authors: J
authors: Shao
authors: Department of Cardiology, Northern Jiangsu People's Hospital, Yangzhou 225000, Jiangsu, China.
authors: Daxin
authors: D
authors: Wang
mesh_terms: D000368:Aged; D002302:Cardiac Output; D002496:Central Venous Pressure; D002985:Clinical Protocols; D003971:Diastole; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006040:Goals; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D019344:Lactic Acid / Q000097:blood; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012151:Resuscitation / Q000379:methods; D012772:Shock, Septic / Q000097:blood / Q000150:complications / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D013566:Sympathomimetics / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D013566:Sympathomimetics; D019344:Lactic Acid; D009638:Norepinephrine