GEDI vs. CVP goal-directed fluid resuscitation for COPD patients with septic shock

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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” Yu et al (2016).

Abstract:

Purpose: 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 two groups. In the control group (n = 37), fluid resuscitation was performed based on the central venous pressure (CVP). In the study group (n = 34), fluid resuscitation was performed until GEDI reached 800 mL/m2.The following indices were observed for the two groups: 6-h and 24-h fluid volumes, norepinephrine (NE) dosage, 24-h 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-h and24-h measurements, the fluid volume was lower and NE 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 two groups.

Conclusions: The GEDI goal-directed fluid resuscitation shows better clinical effects than that shown by CVP for COPD patients with septic shock;however, it cannot reduce the mortality rate.

Reference:

Yu, J., Zheng, R., Lin, H., Chen, Q., Shao, J. and Wang, D. (2016) GEDI vs. CVP goal-directed fluid resuscitation for COPD patients with septic shock: a randomized controlled trial. The American Journal of Emergency Medicine. October 7th. [epub ahead of print].

DOI: http://dx.doi.org/10.1016/j.ajem.2016.10.015

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