Abstract:Objective By mini volume loading test(mVLT) and common carotid artery blood flow peak velocity variability (ΔVpeak_CA),to guide the fluid resuscitation of septic shock patients with mechanical ventilation in ICU,and the value for volume management were evaluated. Methods Sixty-eight septic shock patients who were treated with mechanical ventilation in the Affiliated Hospital of North China University of Science and Technology from June 2017 to December 2018,were enrolled and randomly divided into the ultrasound-guided treatment group (group Ⅰ) and the routine treatment group (group Ⅱ).In group I,mVLT was conducted,and ΔVpeak_CA was measured under the guidance of ultrasound to evaluate the volume status and guide fluid resuscitation.The conventional fluid resuscitation was performed in group Ⅱ.The circulation,perfusion,fluid balance,application of vasoactive drugs,extubation time,ICU stay and urine volume recovery time were compared at different time points before and after treatment between two groups. Results Finally,61 patients were included in the study,including 33 patients in group I and 28 patients in group Ⅱ.There were no significant differences in general clinic data between two groups(all P>0.05).At each point after resuscitation,the indicators of mean arterial pressure (MAP),central venous pressure(CVP),pH,perfusion index (PI),central venous oxygen saturation (ScvO₂%),respiratory rate(RR),heart rate (HR),lactic acid and central renous-to-arterial carbon dioxide partial pressure difference(Pcv-aCO₂) were all significantly better than those before resuscitation (all P<0.05).Although MAP and CVP in group Ⅱ were significantly superior to those in group Ⅰ at some time points after resuscitation (all P<0.05),the indexes of lactic acid,RR,PI,net fluid balance of volume resuscitation,time and dose of noradrenaline use,extubation time,ICU stay and time for urine output more than 0.5 ml·kg^-1·h^-1 in group Ⅰ were statistically better than those in group Ⅱ(all P<0.05). Conclusion For the septic shock patients with mechanical ventilation in ICU,critical ultrasonography combined with mVLT for the volume management can optimize hemodynamics and reduce the medical cost.