Abstract: Objective:To analyze the clinical effect of continuous blood purification (CBP) under the guidance of pulse indication continuous cardiac output monitoring (PiCCO) in the treatment of severe sepsis complicated with stress cardiomyopathy.Methods:A total of 90 patients with septic cardiomyopathy admitted to the ICU of Shiyan People’s Hospital of Bao’an District, Shenzhen were enrolled, and the selected patients were divided into three groups: control group (conventional treatment group), PiCCO group (conventional treatment+PiCCO monitoring group), and CBP group (conventional treatment+PiCCO monitoring+CBP treatment group), with 30 cases in each group.The cardiopulmonary function, hemodynamic indicators, and prognostic indicators of patients in the three groups were compared.Results:After 48 h of treatment, the cardiac index(CI), global ejection fraction(GEF)and oxygenation index(PaO₂/FiO₂)of patients in the CBP group were higher than those in the PiCCO group and the control group (P< 0.05).The global end-diastolic volume index (GEDVI) and extravascular lung water index(EVLWI)were lower than those in the PiCCO group and the control group(P< 0.05).Hemodynamic indicators:the pulmonary vascular resistance index(PVRI), systemic vascular resistance index(SVRI)and central venous pressure (CVP) were lower than those in the PiCCO group and the control group (P< 0.05), and the mean arterial pressure(MAP)was higher than that in the PiCCO group and the control group(P< 0.05).The length of ICU stay and 28-day mortality in the CBP group were lower than those in the PiCCO group and the control group (P< 0.05).Conclusion:CBP therapy under the guidance of PiCCO can effectively stabilize hemodynamic indicators in patients with severe sepsis complicated with stress cardiomyopathy, improve cardiopulmonary function, shorten ICU treatment time, and reduce mortality.