title: 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.
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/FiO2ratio 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.
authors.affiliation: Emergency Center, Shenzhen People's Hospital, Shenzhen, 518020, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Yuanbo
authors.affiliation: Emergency Center, Shenzhen People's Hospital, Shenzhen, 518020, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Jin
authors.affiliation: Emergency Center, Shenzhen People's Hospital, Shenzhen, 518020, China.
authors.forename: Shi
authors.initials: S
authors.lastname: Fei
authors.affiliation: Emergency Center, Shenzhen People's Hospital, Shenzhen, 518020, China.
authors.forename: Long
authors.initials: L
authors.lastname: Liangong
authors.affiliation: Emergency Center, Shenzhen People's Hospital, Shenzhen, 518020, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Xunfa
authors.affiliation: Emergency Center, Shenzhen People's Hospital, Shenzhen, 518020, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Shihai
authors.affiliation: Emergency Center, Shenzhen People's Hospital, Shenzhen, 518020, China. shan928doctor@sina.com.
authors.forename: Shan
authors.initials: S
authors.lastname: Aijun
keywords: Acute respiratory distress syndrome; ICU stay; PaO2/FiO2; PiCCO; Thoracic trauma