Selection of Target Mean Arterial Pressure in Severely Burned Patients with Septic Shock

Abstract

The timely diagnosis of both sepsis and septic shock can be challenging in severely burned patients. Monitoring methods providing early diagnosis of organ dysfunction development are of great importance. Assessment of the glomerular filtration rate with central hemodynamic parameters can be considered as a component of comprehensive monitoring of effectiveness of septic shock therapy.Aim: to determine the relationship between the target mean arterial pressure and glomerular filtration rate parameters in the treatment of severely burned patients with septic shock.Material and methods. 158 severely burned patients with septic shock were included in the study, of them 121 patients represented a retrospective historical group, and 37 patients constituted a prospective group. The main criteria of treatment efficacy were 28-day and hospital mortality.Results. In the patients of prospective group, 28-days mortality decreased down to 16.2% compared with 33.9% in the retrospective group, and hospital mortality dropped down to 29.7% vs 42.1%, respectively (P<0.05). Conclusion. Extended hemodynamic and metabolic (renal function assessment) monitoring of intensive therapy of severely burned patients with septic shock helps targeted adjustment of fluid therapy and provides earlier beginning of extracorporeal blood therapy thus favoring better survival rate.