Abstract: Objective:To investigate the efficacies of pulsed continuous cardiac output (PICCO) and central venous pressure (CVP) monitoring in the treatment of the patients with sepsis shock complicated with cardiac insufficiency, and to clarify the clinical significance of PICCO and CVP monitoring. Methods:A total of 137 cases of septic shock combined with cardiac insufficiency patients were randomly divided into CVP group (n=68) and PICCO group (n=69). The patients in CVP group were treated with CVP monitoring to guide therapy, and the patients in PICCO group were treated with PICCO monitoring to guide therapy.The levels of lactic acid and B brain natriuretic peptide (BNP), central venous oxygen saturation (ScvO₂), heart rate (HR), mean arterial pressure (MAP) and CVP of the patients in two groups were detected before treatment and 6, 24, 48 h after treatment, respectively; the hemodynamic parameters of the patients of PICCO group were recorded; the vasoactive drug use time,the ICU hospitalization time, the incidence rates of multiple organ dysfunction syndrome (MODS), the mechanical ventilation time and the 28 d-mortality rates of the patients were recorded. Results:Compared with CVP group, the levels lactic acid and BNP and HR of the patients in PICCO group at 6, 24, and 48 h after treatment were significantly decreased (P<0.05), and the scavenging rates of lactic acid were significantly increased(P<0.05); the levels of ScvO₂, MAP and CVP were significantly increased (P<0.05). The levels of MAP of the patients in PICCO group were significantly higher than those in CVP group at the same time(P<0.05), after 48 h of treatment, the ScvO₂ levels in PICCO group were significantly higher than those in CVP group at the same time(P<0.05), but there was no significant difference in the CVP levels of the patients between two groups at the same time (P>0.05). There were no significant differences in the incidence rates of MODS and 28 d-mortality rates between two groups(P>0.05); however the use time of vasoactive drugs, the ICU hospitalization time and the mechanical ventilation time of the patients in PICCO group were significantly shorter than those in CVP group (P<0.05). Conclusion:PICCO monitoring guides the treatment of septic shock complicated with cardiac insufficiency better than CVP monitoring, and has positive clinical significance.

Key words: pulse indicator continuous cardiac output, central venous pressure, septic shock, cardiac insufficiency