{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:02:06Z","timestamp":1775624526133,"version":"3.50.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aims to provide a systematic review and meta-analysis of Pulse Indicator Continuous Cardiac Output (PICCO) compared with conventional central venous pressure (CVP) monitoring in the treatment of traumatic shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature retrieval was conducted in databases including PubMed, Web of Science, Cochrane Library, Embase, and China National Knowledge Infrastructure (CNKI) from database inception to October 22, 2024. Keywords such as \u201cPICCO,\u201d \u201ctraumatic shock,\u201d and \u201chemorrhagic shock\u201d were used. Retrieved studies were screened according to pre-determined inclusion and exclusion criteria. The methodological quality and risk of bias were assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies and the Cochrane \u201crisk of bias\u201d tool for randomized controlled trials (RCTs). Outcomes, including mortality, duration of mechanical ventilation, and length of ICU stay, were extracted and meta-analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 15 studies comprising 1,188 patients were included, with 597 monitored by PICCO and 591 by routine CVP. The risk of bias was assessed as low for all studies. PICCO-monitored patients showed a significantly shorter duration of mechanical ventilation compared to the control group [SMD in random effects model: \u22121.66; 95% CI: (\u22122.38, \u22120.94)]. However, no significant differences were found in mortality or length of ICU stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PICCO monitoring can improve the prognosis of traumatic shock patients by shortening the duration of mechanical ventilation, but it does not significantly affect mortality or length of ICU stay. Given the limitations of the included studies, further exploration is warranted to verify these conclusions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1578348","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T06:22:40Z","timestamp":1763101360000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of PICCO monitoring on traumatic shock: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Aihua","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhangyue","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiali","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xun","family":"Ni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"257","DOI":"10.3760\/cma.j.issn.2095-4352.2019.03.001","article-title":"Chinese expert consensus on the clinical application of innovative first-aid resuscitation Technology for Traumatic Shock in 2019","volume":"31","year":"2019","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"999011","DOI":"10.3389\/fphys.2022.999011","article-title":"Danger signals in traumatic hemorrhagic shock and new lines for clinical applications","volume":"13","author":"Dufour-Gaume","year":"2022","journal-title":"Front Physiol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1007\/s11604-014-0354-5","article-title":"Traumatic hypovolemic shock revisited: the spectrum of contrast-enhanced abdominal computed tomography findings and clinical implications for its management","volume":"32","author":"Higashi","year":"2014","journal-title":"Jpn J Radiol"},{"key":"ref4","first-page":"100","article-title":"Application effect of pulse index continuous cardiac output monitoring in the fluid management of infectious shock patients complicated with acute respiratory distress syndrome","volume":"24","author":"Xia","year":"2016","journal-title":"Pract J Cardiac Cerebral Pneumal Vascular Dis"},{"key":"ref5","first-page":"146","article-title":"Expert consensus on acute circulatory failure: clinical practice of Chinese emergency physicians","volume":"25","year":"2016","journal-title":"Chin J Emerg Med"},{"key":"ref6","first-page":"300","article-title":"Myocardial dysfunction and its prognostic utility in sepsis and septic shock","volume":"59","author":"Delgado-Serrano","year":"2021","journal-title":"Rev Med Inst Mex Seguro Soc"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1093\/bja\/aeu554","article-title":"Pulmonary blood volume measured by contrast enhanced ultrasound: a comparison with transpulmonary thermodilution","volume":"115","author":"Herold","year":"2015","journal-title":"Br J Anaesth"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1007\/s00134-014-3638-4","article-title":"Effectiveness of treatment based on Picco parameters in critically ill patients with septic shock and\/or acute respiratory distress syndrome: a randomized controlled trial","volume":"41","author":"Zhang","year":"2015","journal-title":"Intensive Care Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/s13613-016-0217-6","article-title":"ICU management based on PiCCO parameters reduces duration of mechanical ventilation and ICU length of stay in patients with severe thoracic trauma and acute respiratory distress syndrome","volume":"6","author":"Yuanbo","year":"2016","journal-title":"Ann Intensive Care"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e061601","DOI":"10.1136\/bmjopen-2022-061601","article-title":"Evaluating an oral health programme for the prevention of dental decay among school-aged children in China: protocol for a mixed-methods study based on the re-aim framework","volume":"12","author":"Wang","year":"2022","journal-title":"BMJ Open"},{"key":"ref11","first-page":"75","article-title":"Analysis of the value of PICCO monitoring in the treatment of patients with hemorrhagic shock combined with pulmonary edema","volume":"10","author":"Fang","year":"2016","journal-title":"For All Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"47","DOI":"10.16662\/j.cnki.1674-0742.2018.08.047","article-title":"Application of PiCCO in treatment of traumatic shock","volume":"37","author":"Lin","year":"2018","journal-title":"China Foreign Med Treat"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"44","DOI":"10.3969\/j.issn.1002-1949.2018.z1.034","article-title":"The role of PiCCO in the management of traumatic shock","volume":"38","author":"Lin","year":"2018","journal-title":"Chin J Crit Care Med"},{"key":"ref14","first-page":"118","article-title":"A study of the value of guided fluid resuscitation under PICCO monitoring techniques in patients with hemorrhagic shock due to chest trauma","volume":"21","author":"Lin","year":"2021","journal-title":"Pract Clin J Integr Trandit Chin West Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.3892\/etm.2016.3040","article-title":"Application strategy of PiCCO in septic shock patients","volume":"11","author":"Liu","year":"2016","journal-title":"Exp Ther Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1016\/j.ajem.2015.04.031","article-title":"Improved Sepsis bundles in the treatment of septic shock: a prospective clinical study","volume":"33","author":"Lu","year":"2015","journal-title":"Am J Emerg Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"78","DOI":"10.3969\/j.issn.1004-6763.2020.06.043","article-title":"The value of cardiorespiratory volume monitoring (Picco) in the treatment of traumatic shock","volume":"34","author":"Ma","year":"2020","journal-title":"Contin Med Educ"},{"key":"ref18","first-page":"130","article-title":"Evaluation of Picco-oriented fluid resuscitation strategies in the acute phase of traumatic shock","volume":"37","author":"Meng","year":"2019","journal-title":"J Prev Med Chin Peoples Liberation Army"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"4431","DOI":"10.1177\/00031348221087898","article-title":"The application of Picco-guided fluid resuscitation in patients with traumatic shock","volume":"89","author":"Ni","year":"2023","journal-title":"Am Surg"},{"key":"ref20","first-page":"65","article-title":"Transpulmonary thermodilution technique in application of traumatic shock","volume":"52","author":"Shi","year":"2017","journal-title":"Chin J Med"},{"key":"ref21","first-page":"57","article-title":"The value of PiCCO monitoring in the management of patients with hemorrhagic shock combined with pulmonary edema","volume":"53","author":"Xue","year":"2013","journal-title":"Shandong Med J"},{"key":"ref22","first-page":"3432","article-title":"Analysis of the effect of fluid resuscitation guided by the PiCCO technique on ci, blood lactate and evlwi levels in patients with emergency traumatic shock","volume":"32","author":"Yang","year":"2021","journal-title":"Modern Diagnosis Treatment"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"22","DOI":"10.3760\/cma.j.issn.2095-4352.2015.01.006","article-title":"Value of pulse indicator continuous cardiac output monitoring of cardiac function in septic shock patients: a prospective study","volume":"27","author":"Yi","year":"2015","journal-title":"Chin Crit Care Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"136","DOI":"10.3760\/cma.j.cn501120-20200908-00403","article-title":"Application of pulse contour cardiac output monitoring technology in fluid resuscitation of severe burn patients in shock period","volume":"37","author":"Yu","year":"2021","journal-title":"Chin J Burns Wounds"},{"key":"ref25","first-page":"42","article-title":"Application of PiCCO-guided limited fluid resuscitation in rescue of severe traumatic hemorrhagic shock","volume":"32","author":"Zhang","year":"2021","journal-title":"Hainan Yi Xue Yuan Xue Bao"},{"key":"ref26","first-page":"146","article-title":"Clinical study on the application of PiCCO in the liquid resuscitation in patients with chest trauma","volume":"20","author":"Zhuge","year":"2017","journal-title":"Chin Gen Pract"},{"key":"ref27","first-page":"116","article-title":"An observational study on the treatment methods and effects of fluid resuscitation strategies in patients with traumatic shock","volume":"6","author":"Bian","year":"2021","journal-title":"Doctor"},{"key":"ref28","first-page":"65","article-title":"Transpulmonary thermodilution technique in application of traumatic shock","volume":"52","author":"Chun-zhi","year":"2017","journal-title":"Chin Med J"},{"key":"ref29","first-page":"118","article-title":"Study on the application value of PICCO monitoring technology in guiding fluid resuscitation in patients with hemorrhagic shock caused by chest trauma","volume":"21","author":"Wen-qing","year":"2021","journal-title":"Pract Clin Appl Integrated Tradit Chin Western Med"},{"key":"ref30","first-page":"57","article-title":"The application value of PICCO monitoring in the treatment of patients with hemorrhagic shock complicated with pulmonary edema","volume":"53","author":"Feng","year":"2013","journal-title":"Shandong Med"},{"key":"ref31","first-page":"130","article-title":"Evaluation of PiCCO-guided fluid resuscitation strategy in the acute phase of traumatic shock","volume":"37","author":"Wei-de","year":"2019","journal-title":"J Mil Prev Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"6093","DOI":"10.3390\/jcm11206093","article-title":"Comparison between fourth-generation Flotrac\/Vigileo system and continuous Thermodilution technique for cardiac output estimation after time adjustment during off-pump coronary artery bypass graft surgery: a retrospective cohort study","volume":"11","author":"Oh","year":"2022","journal-title":"J Clin Med"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"R212","DOI":"10.1186\/cc9335","article-title":"Cross-comparison of cardiac output trending accuracy of LiDCO, PiCCO, FloTrac and pulmonary artery catheters","volume":"14","author":"Hadian","year":"2010","journal-title":"Crit Care"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1093\/bja\/aes420","article-title":"Pressure recording analytical method for measuring cardiac output in critically ill children: a validation study","volume":"110","author":"Saxena","year":"2013","journal-title":"Br J Anaesth"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.jclinane.2017.12.022","article-title":"A Mini-fluid challenge of 150ml predicts fluid responsiveness using Modelflow(R) pulse contour cardiac output directly after cardiac surgery","volume":"46","author":"Smorenberg","year":"2018","journal-title":"J Clin Anesth"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/8604322","article-title":"Effect of pulse Indicator continuous cardiac output monitoring on septic shock patients: a meta-analysis","volume":"2022","author":"Wang","year":"2022","journal-title":"Comput Math Methods Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1007\/s12630-014-0135-8","article-title":"Semi-invasive measurement of cardiac output based on pulse contour: a review and analysis","volume":"61","author":"Schl\u00f6glhofer","year":"2014","journal-title":"Can J Anesth\/J Can Anesth"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.14188\/j.1671-8852.2023.0042","article-title":"Evaluation of the efficacy of PICCO monitoring for fluid resuscitation in septic shock patients with ARDS: a meta-analysis","volume":"44","author":"Liu","year":"2023","journal-title":"Med J Wuhan Univ"},{"key":"ref39","article-title":"Meta-analysis of PICCO monitoring and guiding the use of vasoactive drugs in the treatment of septic shock patients","author":"Pan","year":"2023"},{"key":"ref40","first-page":"934","article-title":"Efficacy of pulse indicating continuous cardiac output monitoring on the treatment guidance of patients with septic shock: a meta-analysis","volume":"17","author":"Zhu","year":"2017","journal-title":"Chin J Evid Based Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1094845","DOI":"10.3389\/fphys.2023.1094845","article-title":"Shock-induced Endotheliopathy (Shine): a mechanistic justification for Viscoelastography-guided resuscitation of traumatic and non-traumatic shock","volume":"14","author":"Bunch","year":"2023","journal-title":"Front Physiol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1053\/j.jvca.2024.10.021","article-title":"Protective hemodynamics: CLEAR!","volume":"39","author":"D'Amico","year":"2025","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"101316","DOI":"10.1016\/j.tacc.2023.101316","article-title":"Prediction of fluid responsiveness in critical care: current evidence and future perspective","volume":"54","author":"La Via","year":"2024","journal-title":"Trends Anaesth Crit Care"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"e000411","DOI":"10.1136\/tsaco-2019-000411","article-title":"Contemporary hemodynamic monitoring, fluid responsiveness, volume optimization, and endpoints of resuscitation: an AAST critical care committee clinical consensus","volume":"5","author":"Martin","year":"2020","journal-title":"Trauma Surg Acute Care Open"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1097\/mcc.0000000000001205","article-title":"Protective hemodynamics: a novel strategy to manage blood pressure","volume":"30","author":"D'Amico","year":"2024","journal-title":"Curr Opin Crit Care"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"e14288","DOI":"10.1111\/jep.14288","article-title":"Association does not mean causation, when observational data were misinterpreted as causal: the observational interpretation fallacy","volume":"31","author":"D'Amico","year":"2025","journal-title":"J Eval Clin Pract"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1578348\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T06:22:47Z","timestamp":1763101367000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1578348\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,14]]},"references-count":46,"alternative-id":["10.3389\/fmed.2025.1578348"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1578348","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,14]]},"article-number":"1578348"}}