Abstract:ObjectiveTo investigate the value of pulse indicator continuous cardiac output (PiCCO) monitoring in the treatment of diabetes patients with refractory septic shock. Methods A total of 139 patients with refractory septic shock admitted to the Second Affiliated Hospital of Nanjing Medical University from April 2017 to December 2020 were selected for a retrospective study. Patients with diabetes (DM+P, n=22) and non-diabetes (NDM+P, n=39) who received PiCCO monitoring were selected as the observation group, and patients with diabetes (DM+NP, n=27) and non diabetes (NDM+NP, n=51) who did not receive PiCCO monitoring were selected as the control group. The observation group was treated with goal-directed therapy under PiCCO monitoring, while the control group was treated with traditional cluster therapy. The 28-day all-cause mortality, the duration of ICU stay, and acute physiology and chronic health evaluation (APACHE) Ⅱ scores and sequential organ failure score (SOFA) at 72 hours of resuscitation were compared among four groups. Results There was no statistically significant difference between the observation group and the control group in terms of mortality at 28 days and SOFA score at 72 hours of resuscitation (P＞0.05). The APACHE Ⅱ score of the NDM+P group was significantly lower than that of the other three groups at 72 hours of resuscitation (P＜0.05), and the duration of ICU stay was shorter than that of the DM+NP group ［7(3,11)d vs 12(8,22)d, P＜0.05］. Conclusion Goal-directed therapy under PiCCO monitoring can not reduce the 28-day all-cause mortality of diabetes patients with refractory septic shock, but may improve the APACHE Ⅱ score of non-diabetes patients with refractory septic shock at 72 h of resuscitation.