A study demonstrated the predictive value of Pulse indicate Contour Cardiac Output (PiCCO) monitoring technique combined with troponin I (cTnI) detection in septic myocardial dysfunction (SMD) of the elderly.

The study enrolled 119 elderly patients with SMD who were allocated into-

The joint group (JG) for capacity management of fluid resuscitation under the guidance of PiCCO monitoring technique and cTnI detection

The control group (CG) for conventional capacity management. 

The groups were compared for-

Clinical indicators, hemodynamics, myocardial injury markers improvement and inflammatory factors 6 h and 36 h post-intervention, fluid balance 6 h, 12 h and 36 h post-intervention, drug consumption (norepinephrine), treatment effect and 28-day hospitalization mortality.

The results obtained from the study can be described as follows--

After resuscitation, JG showed higher urine volume per hour and the fluid resuscitation volume as compared to CG

After resuscitation, JG showed blood lactic acid (BLA) expression as compared to CG. 

After resuscitation, JG showed a remarkably lower central venous pressure (CVP) than CG, with notably higher mean arterial pressure (MAP) and central venous oxygen saturation (ScvO2). 

Dramatically lower cTnI and N-terminal pro-brain natriuretic peptide (NT-ProBNP) 6 h and 36 h post-intervention were observed in JG contrasting to that of CG.

Reduced interleukin-6 (IL-6), procalcitonin (PCT), and high-sensitivity C-reactive protein (hs-CRP) were observed in JG contrasting to that of CG.

After 36 h of intervention, the fluid balance became lower in JG than in CG. 

JG also demonstrated statistically lower use of norepinephrine, lower time of mechanical ventilation and ICU stay, noticeably lower incidence of multiple organ dysfunction syndromes (MODS), and dramatically lower 28-day hospitalization mortality contrasting CG post-intervention.

Thus PiCCO monitoring technique combined with cTnI detection was rendered to be high-performing in fluid resuscitation of elderly patients with SMD. It can be utilized to improve the myocardial function of patients, reduce medication and facilitate disease recovery.

Source: Am J Transl Res. 2021 Jun 15;13(6):6846-6854. PMID: 34306435; PMCID: PMC8290674.