To explore the comparison of pulse-indicated continuous cardiac output and central venous pressure-guided volume expansion on hemodynamics in patients with septic shock complicated with myocardial depression.

84 patients with septic shock and myocardial depression admitted to Xi'an Red Cross Hospital from January 2023 to January 2025 were selected as the research subjects, with 42 cases in each group. There were 22 males and 20 females in the observation group, aged 41-62 years [(53.71±4.26) years]. The control group consisted of 24 males and 18 females, aged 40-64 years [(53.75±4.24) years]. Patients in the control group received volume resuscitation guided by central venous pressure, while those in the observation group were treated with pulse indicator continuous cardiac output monitoring. The hemodynamics [systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), central venous pressure (CVP)], urine volume and urine balance volume before treatment, 24 hours after treatment and 48 hours after treatment were compared between the two patient groups, the blood gas indicators [oxygenation index (PaO₂/FiO₂), partial pressure of carbon dioxide in arterial blood (PaCO₂)], Acute Physiology and Chronic Health score (APACHE-II), Sequential Organ Failure Assessment (SOFA) scale before treatment and one week after treatment were compared between the two patient groups, at discharge, the mechanical ventilation time, the length of stay in the ICU, and the mortality rate during the 28-day follow-up were compared between the two patient groups.

There was a significant interaction between time and group for SBP, DBP, MAP, and CVP in both patient groups (P<0.05). At 24 h and 48 h after treatment, the observation group exhibited lower SBP and DBP but higher MAP and CVP compared to the control group (P<0.05). Significant interactions were also observed for urine output and fluid balance between time and group (P<0.05). At 24 h and 48 h after treatment, the observation group showed higher urine output and fluid balance than the control group (P<0.05). After one week of treatment, the observation group had higher PaO₂/FiO₂ and PaCO₂ levels than the control group (P<0.05). Additionally, the observation group demonstrated lower APACHE-II and SOFA scores than the control group (P<0.05). The observation group required shorter durations of mechanical ventilation and ICU stays (P<0.05), and had a lower 28-day mortality rate compared to the control group (P<0.05).

Compared with volume expansion guided by central venous pressure, continuous cardiac output indicated by pulse has more obvious improvement on hemodynamics in septic shock complicated with myocardial depression, which can improve blood gas indicators and reduce mortality.