Background: This study aimed to assess whether a management algorithm using data obtained with a PiCCO system\ncan improve clinical outcomes in critically ill patients with acute respiratory distress syndrome (ARDS).\nResults: The PaO2/FiO2 ratio increased over time in both groups, with a sharper increase in the PiCCO group. There\nwas no difference in 28-day mortality (3.2 vs. 3.6%, P = 0.841). Days on mechanical ventilation (3 vs. 5 days, P = 0.002)\nand ICU length of stay (6 vs. 11 days, P = 0.004) were significantly lower in the PiCCO group than in the CVP group.\nTreatment costs were lower in the PiCCO group than in the CVP group. Multivariate logistic regression model\nshowed that the monitoring method (PiCCO vs. CVP) was independently associated with the length of ICU stay [odds\nratio (OR) 3.16, 95% confidence interval (95% CI) 1.55ââ?¬â??6.63, P = 0.001], as well as shock (OR 3.41, 95% CI 1.74ââ?¬â??6.44,\nP = 0.002), shock and ARDS (OR 3.46, 95% CI 1.79ââ?¬â??6.87, P = 0.002), and APACHE II score (OR 1.17, 95% CI 1.02ââ?¬â??1.86,\nP = 0.014).\nConclusions: This study investigated the usefulness of the PiCCO system in improving outcomes for patient with\nsevere thoracic trauma and ARDS and provided new evidence for fluid management in critical care settings.
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