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1.Basic Information
1.1.Basic Information

name

wmh

sex

male

age

43

hospital number

17032025

height

162 cm

weight

57 kg

BSA

1.621 m2

APACHEⅡ

18

Infection source

urinary

date

2017/9/16 年/月/日

Sequential Organ Failure Assessment

Fluid resuscitation

CVP8-12 mmHg
/
MAP≥65 mmHg
/
ScvO2≥70%

1.2.Inclusion Criteria

age>=60

no

septic shock

yes

mechanical ventilation

Early fluid resuscitation

yes

1.3.Exclusion Criteria

age<60

yes

Pregnant woman

no

advanced malignant tumor

Pulmonary interstitial fibrosis

Serious arrhythmia

Small Tidal Volume Ventilation

Liver failure

Refuse to participate

1.4.Past medical history

Heart disease

no

yes

no

no

no

no

2.T0
1.

yes

亚胺培南西司他丁钠

vasoactive agent

no

15 min

30 min

15 min

2.vital signs

Temperature

37.2

Heart Rate

101 次/分

Breath

15 次/分

Systolic pressure (SP)

89 mmHg

Diastolic pressure

59 mmHg

mean arterial pressure

72 mmHg

3.Blood Gas Analysis

Pcv-aCO2

4 mmHg

DO2

601.63

VO2

134.36

Ca-vO2

25.73

2.3.、arterial blood gas analysis

pH value

7.37

PaO2

171 mmHg

PaCO2

30 mmHg

BE

-7.3 mmol/L(±2.3mmol/L)

SaO2

99.4 %

Blood lactic acid concentration, LAC

2.5 mmol/L

Oxygenation index (PaO2/FiO2)

518.18 mmHg

2.3.、Central venous blood gas analysis

pH value

7.3

PcvO2

61 mmHg

PcvCO2

34 mmHg

BE

-8.5 mmol/L

ScvO2

77.1 %

4.vasoactive agent and fluid

Volume of input

ml

Volume of output

210 ml

Volume of urine

210 ml

ultrafiltration volume

0 ml

norepinephrine

no

Norepinephrine Dosage

μg/Kg/min

dopamine

no

Dopamine Dosage

μg/Kg/min

Dobutamine

No

Dobutamine Dosage

μg/Kg/min

5.PiCCO parameters

CVP

7 mmHg

cardiac output

5.29 L/min

cardiac index

3.52 L/min/m2

stroke volume

51 ml

Stroke Index

36 ml/m2

ITBVI

818 ml/m2

GEDVI

654 ml/m2

EVLWI

6 ml/kg

PVPI

1.2

SVRI

1759 DSm2/cm5

CFI

5.6

GEF

22 %

SVV

10 %

PPV

6 %

dPmax

1249

6.Cardiac Ultrasound

LVEF

%

FS

%

SV

ml

CO

L/min

E peak

A peak

E/A

Ea(ventricular septum)

Ea(lateral wall)

E/Ea(ventricular septum)

E/Ea(lateral wall)

MAPSE

mm

TAPSE

mm

RV size

LVEDV

ml

LVEDD

cm

7.lung ultrasound

the number of B line

LUS

00

B+ Zone

8.inferior vena cava
2.8.1.、

IVC(inspiratory phase)

18.1 mm

IVC(expiratory phase)

16.4 mm

respiratory variations of inferior vena cavae diameter

9.86 %

2.8.2.、

mm

mm

mm

mm

3.T6
7..Inferior Vena Cava
3.7..1、

IVC(inspiratory phase)

18.1 mm

IVC(expiratory phase)

16.4 mm

Respiratory variations of inferior vena cavae diameter

9.86 %

3.7..2、

mm

mm

mm

mm

1..Vital Signs

Temperature

36.5

Heart Rate

108 次/分

Breath

16 次/分

Systolic Pressure

106 mmHg

Diastolic Pressure

62 mmHg

Mean Arterial Pressure

76 mmHg

2..Blood Gas Analysis

Pcv-aCO2

6.0 mmHg

DO2

619.68

VO2

130.01

Ca-vO2

22.98

3.2..、Arterial Blood Gases

PH value

7.34

PaO2

95.2 mmHg

PaCO2

26 mmHg

BE

-10.9 mmol/L

SaO2

96.50 %

Blood Lactic Acid Concentration

1.9 mmol/L

Oxygenation index (PaO2/FiO2)

288.48 mmHg

3.2..、Venous Blood Gas

PH value

7.31

PcvO2

51.3 mmHg

PcvCO2

32 mmHg

BE

-10.1 mmol/L

ScvO2

76.20 %

3..Vasoactive Agent and Fluid

Volume of input

ml

Volume of output

880 ml

Volume of urine

650 ml

Ultrafiltration Volume

150 ml

Norepinephrine Dosage

mg

Dopamine Dosage

mg

Epinephrine Dosage

mg

Pituitrin Dosage

U

Dobutamine Dosage

mg

Milrinone Dosage

mg

Levosimendan

no

4..PiCCO Parameters

CVP

9 mmHg

cardiac output

5.69 L/min

cardiac index

3.55 L/min/m2

stroke volume

55 ml

Stroke Index

37 ml/m2

ITBVI

851 ml/m2

GEDVI

720 ml/m2

EVLWI

8 ml/kg

PVPI

1.3

SVRI

1920 DSm2/cm5

CFI

5.5

GEF

24.0 %

SVV

11.0 %

PPV

6 %

dPmax

1360

5..Cardiac Ultrasound

LVEF

%

FS

%

SV

ml

CO

L/min

E peak

A peak

E/A

Ea(ventricular septum)

Ea(lateral wall)

E/Ea(ventricular septum)

E/Ea(lateral wall)

MAPSE

mm

TAPSE

mm

RV size

LVEDV

ml

LVEDD

cm

6..Lung Ultrasound

The number of B line

LUS

0

B+ Zone

4.T12
1..Vital Signs

Temperature

36.8

Heart Rate

133 次/分

Breath

15 次/分

Systolic Pressure

86 mmHg

Diastolic Pressure

61 mmHg

Mean Arterial Pressure

71 mmHg

2..Blood Gas Analysis

Pcv-aCO2

4.0 mmHg

DO2

759.39

VO2

145.97

Ca-vO2

21.34

4.2..、Arterial Blood Gas

PH value

7.29

PaO2

101 mmHg

PaCO2

26 mmHg

BE

-13.1 mmol/L

SaO2

96.5 %

Blood Lactic Acid Concentration

2 mmol/L

Oxygenation index (PaO2/FiO2)

306.06 mmHg

4.2..、Venous Blood Gas

PH value

7.27

PcvO2

50 mmHg

PcvCO2

30 mmHg

BE

-12.1 mmol/L

ScvO2

77.90 %

3..Vasoactive Agent and Fluid

Volume of input

ml

Volume of output

1780 ml

Volume of urine

1400 ml

Ultrafiltration Volume

300 ml

Norepinephrine Dosage

mg

Dopamine Dosage

mg

Epinephrine Dosage

mg

Pituitrin Dosage

U

Dobutamine Dosage

mg

Milrinone Dosage

mg

Levosimendan

no

4..PiCCO Parameters

CVP

6 mmHg

cardiac output

6.89 L/min

cardiac index

3.6 L/min/m2

stroke volume

52 ml

Stroke Index

25 ml/m2

ITBVI

888 ml/m2

GEDVI

711 ml/m2

EVLWI

13 ml/kg

PVPI

2.7

SVRI

1360 DSm2/cm5

CFI

5.5

GEF

16.0 %

SVV

11.0 %

PPV

23 %

dPmax

1900

5..Cardiac Ultrasound

LVEF

%

FS

%

SV

ml

CO

L/min

E peak

A peak

E/A

Ea(ventricular septum)

Ea(lateral wall)

E/Ea(ventricular septum)

E/Ea(lateral wall)

MAPSE

mm

TAPSE

mm

RV size

LVEDV

ml

LVEDD

cm

6..Lung Ultrasound

The number of B line

LUS

0

B+ Zone

7..Inferior Vena Cava
4.7..1、

IVC(inspiratory phase)

20.3 mm

IVC(expiratory phase)

18.6 mm

Respiratory variations of inferior vena cavae diameter

8.74 %

4.7..2、

mm

mm

mm

mm

5.T24
1.Vital Signs

Temperature

36.6

Heart Rate

70 次/分

Breath

14 次/分

Systolic Pressure

135 mmHg

Diastolic Pressure

80 mmHg

Mean Arterial Pressure

101 mmHg

2.Blood Gas Analysis

Pcv-aCO2

4.5 mmHg

DO2

450.99

VO2

89.28

Ca-vO2

20.19

5.2.、Arterial Blood Gas

PH value

7.37

PaO2

104 mmHg

PaCO2

33.5 mmHg

BE

-5.6 mmol/L

SaO2

97.70 %

Blood Lactic Acid Concentration

2.4 mmol/L

Oxygenation index (PaO2/FiO2)

315.15 mmHg

5.2.、Venous Blood Gas

PH value

7.34

PcvO2

46 mmHg

PcvCO2

38 mmHg

BE

-4.9 mmol/L

ScvO2

78.3 %

3.Vasoactive Agent and Fluid

Volume of input

ml

Volume of output

ml

Volume of urine

2700 ml

Ultrafiltration Volume

316 ml

Norepinephrine Dosage

mg

Dopamine Dosage

mg

Epinephrine Dosage

mg

Pituitrin Dosage

U

Dobutamine Dosage

mg

Milrinone Dosage

mg

Levosimendan

no

4.PiCCO Parameters

CVP

17 mmHg

cardiac output

4.46 L/min

cardiac index

2.96 L/min/m2

stroke volume

65 ml

Stroke Index

44 ml/m2

ITBVI

951 ml/m2

GEDVI

761 ml/m2

EVLWI

7 ml/kg

PVPI

1.1

SVRI

2992 DSm2/cm5

CFI

4

GEF

22.0 %

SVV

5.0 %

PPV

6 %

dPmax

1352

5.Cardiac Ultrasound

LVEF

%

FS

%

SV

ml

CO

L/min

E peak

A peak

E/A

Ea(ventricular septum)

Ea(lateral wall)

E/Ea(ventricular septum)

E/Ea(lateral wall)

MAPSE

mm

TAPSE

mm

RV size

LVEDV

ml

LVEDD

cm

6.Lung Ultrasound

The number of B line

LUS

B+ Zone

7.Inferior Vena Cava
5.7.1、

IVC(inspiratory phase)

21.5 mm

IVC(expiratory phase)

19.1 mm

Respiratory variations of inferior vena cavae diameter

11.82 %

5.7.2、

mm

mm

mm

mm

6.T48
1.Vital Signs

Temperature

Heart Rate

次/分

Breath

次/分

Systolic Pressure

mmHg

Diastolic Pressure

mmHg

Mean Arterial Pressure

mmHg

2.Blood Gas Analysis

Pcv-aCO2

5.6 mmHg

DO2

0

VO2

0

Ca-vO2

17.81

6.2.、Arterial Blood Gas

PH value

7.45

PaO2

101 mmHg

PaCO2

31.8 mmHg

BE

-2 mmol/L

SaO2

98.10 %

Blood Lactic Acid Concentration

1.4 mmol/L

Oxygenation index (PaO2/FiO2)

306.06 mmHg

6.2.、Venous Blood Gas

PH value

7.41

PcvO2

42 mmHg

PcvCO2

37.4 mmHg

BE

-0.8 mmol/L

ScvO2

79.30 %

3.Vasoactive Agent and Fluid

Volume of input

ml

Volume of output

ml

Volume of urine

ml

Ultrafiltration Volume

ml

Norepinephrine Dosage

mg

Dopamine Dosage

mg

Epinephrine Dosage

mg

Pituitrin Dosage

U

Dobutamine Dosage

mg

Milrinone Dosage

mg

Levosimendan

4.PiCCO Parameters

CVP

mmHg

cardiac output

L/min

cardiac index

L/min/m2

stroke volume

ml

Stroke Index

ml/m2

ITBVI

ml/m2

GEDVI

ml/m2

EVLWI

ml/kg

PVPI

SVRI

DSm2/cm5

CFI

GEF

%

SVV

%

PPV

%

dPmax

5.Cardiac Ultrasound

LVEF

%

FS

%

SV

ml

CO

L/min

E peak

A peak

E/A

Ea(ventricular septum)

Ea(lateral wall)

E/Ea(ventricular septum)

E/Ea(lateral wall)

MAPSE

mm

TAPSE

mm

RV size

LVEDV

ml

LVEDD

cm

6.Lung Ultrasound

The number of B line

LUS

B+ Zone

7.Inferior Vena Cava
6.7.1、

IVC(inspiratory phase)

mm

IVC(expiratory phase)

mm

Respiratory variations of inferior vena cavae diameter

%

6.7.2、

mm

mm

mm

mm

7.T72
1.Vital Signs

Temperature

Heart Rate

次/分

Breath

次/分

Systolic Pressure

mmHg

Diastolic Pressure

mmHg

Mean Arterial Pressure

mmHg

2.Blood Gas Analysis

Pcv-aCO2

6.0 mmHg

DO2

0

VO2

0

Ca-vO2

21.19

7.2.、Arterial Blood Gas

PH value

7.45

PaO2

94 mmHg

PaCO2

32.5 mmHg

BE

-1.3 mmol/L

SaO2

97.70 %

Blood Lactic Acid Concentration

1.2 mmol/L

Oxygenation index (PaO2/FiO2)

284.85 mmHg

7.2.、Venous Blood Gas

PH value

7.4

PcvO2

40 mmHg

PcvCO2

38.5 mmHg

BE

-0.9 mmol/L

ScvO2

76.20 %

3.Vasoactive Agent and Fluid

Volume of input

ml

Volume of output

ml

Volume of urine

ml

Ultrafiltration Volume

ml

Norepinephrine Dosage

mg

Dopamine Dosage

mg

Epinephrine Dosage

mg

Pituitrin Dosage

U

Dobutamine Dosage

mg

Milrinone Dosage

mg

Levosimendan

4.PiCCO Parameters

CVP

mmHg

cardiac output

L/min

cardiac index

L/min/m2

stroke volume

ml

Stroke Index

ml/m2

ITBVI

ml/m2

GEDVI

ml/m2

EVLWI

ml/kg

PVPI

SVRI

DSm2/cm5

CFI

GEF

%

SVV

%

PPV

%

dPmax

5.Cardiac Ultrasound

LVEF

%

FS

%

SV

ml

CO

L/min

E peak

A peak

E/A

Ea(ventricular septum)

Ea(lateral wall)

E/Ea(ventricular septum)

E/Ea(lateral wall)

MAPSE

mm

TAPSE

mm

RV size

LVEDV

ml

LVEDD

cm

6.Lung Ultrasound

The number of B line

LUS

B+ Zone

7.Inferior Vena Cava
7.7.1、

IVC(expiratory phase)

mm

Respiratory variations of inferior vena cavae diameter

%

IVC(inspiratory phase)

mm

7.7.2、

mm

mm

mm

mm

8.Day 1
1.Cardiac Function Indices

NT-proBNP

pg/ml

BNP

1330 pg/ml

cTNI

3.62 ng/ml

Creatine kinase isoenzyme, CKMB

103 U/L

2.Renel Function Indices

Creatinine

175 umol/L

Urea nitrogen

12.55 mmol/l

MDRD

ml/min/1.73m2

Date of examination

yyyy-mm-dd

3.Blood Routine Tests

WBC

7 X10*9/L

neutrophilic granulocyte percentage

97.4 %

Hb

g/L

CRP

123 mg/L

Procalcitonin, PCT

>100 ng/ml

Date of test

4.Sequential Organ Failure Assessment

Sequential Organ Failure Assessment

9.Day 2
1.Cardiac Function Indices

NT-proBNP

pg/ml

BNP

1170 pg/ml

cTNI

2115 ng/ml

Creatine kinase isoenzyme, CKMB

88 U/L

2.Renel Function Indices

Creatinine

109 umol/L

Urea nitrogen

6.52 mmol/l

MDRD

ml/min/1.73m2

3.Blood Routine Tests

WBC

32.2 X10*9/L

neutrophilic granulocyte percentage

96.1 %

Hb

g/L

CRP

221 mg/L

Procalcitonin, PCT

43.7 ng/ml

4.Sequential Organ Failure Assessment

Sequential Organ Failure Assessment

10.Day 3
1.Cardiac Function Indices

NT-proBNP

pg/ml

BNP

1330 pg/ml

cTNI

1.99 ng/ml

Creatine kinase isoenzyme, CKMB

83 U/L

2.Renel Function Indices

Creatinine

83.5 umol/L

Urea nitrogen

6.34 mmol/L

MDRD

ml/min/1.73m2

3.Blood Routine Tests

WBC

23.4 X10*9/L

neutrophilic granulocyte percentage

93.4 %

Hb

g/L

CRP

80 mg/L

Procalcitonin, PCT

2.8 ng/ml

4.Sequential Organ Failure Assessment

Sequential Organ Failure Assessment

11.At the end of the study
4.1.

Transfusion of Red Cells

Transfusion of Red Cells

U

Plasma infusion

Plasma infusion

ml

platelet transfusion

platelet transfusion

U

APACHEⅡ

Complication

no

4.2.prognosis

prognosis

28-day mortality

survival time(day)

death time

yyyy/mm/dd

diagnosis of death

length of stay

duration in ICU

duration of mechanical ventilation

小时

ICU expenses

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy

小时