To evaluate the effect of fluid resuscitation guided by hemodynamic monitoring in patients with sepsis.

This prospective randomized controlled trial enrolled 100 patients with sepsis who were admitted to Qinghai Provincial Fourth People's Hospital from January 2023 to December 2024. The patients were randomly divided into a control group and an observation group, with 50 cases in each group. The observation group received fluid resuscitation guided by advanced hemodynamic monitoring, while the control group received standard guideline-based fluid resuscitation. Clinical indicators were compared between the two groups, including vital sign and blood gas parameters at 0 h, 6 h, 12 h, and 24 h. These parameters included blood pressure (systolic and diastolic), heart rate, central venous pressure (CVP), mean arterial pressure (MAP), pH, partial pressure of oxygen (PaO₂), partial pressure of carbon dioxide (PaCO₂), lactate (Lac), cardiac output (SV), stroke volume variation (SVV), and pulse pressure variation (PPV), as well as preload (global end-diastolic volume) and extravascular lung water indicators obtained via PICCO monitoring. Additional measures included the oxygenation index (PaO₂/FiO₂), duration of mechanical ventilation, severity scores (sequential organ failure assessment [SOFA] score, quick SOFA [qSOFA] score, and 24-hour Acute Physiology and Chronic Health Evaluation [APACHE Ⅱ] scores), fluid volume at various time nodes, vasoactive drug dosage, fluid balance, and length of ICU stay.

At 6 h, 12 h, and 24 h after admission, patients in the observation group showed significantly better vital signs, blood gas parameters, and hemodynamic parameters compared to the control group (P＜0.05). The observation group also exhibited a higher PaO₂/FiO₂ ratio, shorter duration of mechanical ventilation. and lower qSOFA, SOFA , and 24-hour APACHE Ⅱ scores, as well as reduced vasoactive drug dosage (P＜0.05). Furthermore, while the fluid balance volume was higher in the observation group, the length of ICU stay was significantly shorter (P＜0.05).

Implementing hemodynamic monitoring to guide fluid resuscitation in septic patients can more accurately guide clinical decision-making, improve patient outcome, and shorten recovery time.