[The therapeutic effects of fluid resuscitation in severe sepsis and septic shock]

To evaluate the therapeutic effect of fluid resuscitation on severe sepsis and septic shock.

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.

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).

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.