Abstract: Objective To observe the application effect of pulse indicator continuous cardiac output(PICCO)for patients with severe sepsis complicated with acute heart failure treated by recombinant human brain natriuretic peptide. Methods A total of 40 patients with severe sepsis complicated with heart failures were selected as study objects, and were randomly divided into study group and control group, with 20 cases in each group. The control group was given anti-heart failure drugs, while the study group was additionally treated by recombinant human brain natriuretic peptide based on the control group. PICCO monitor was used to detect cardiac index(CI), stroke volume index(SVI), global end-diastolic volume index(GEDI), extracascular lung water index(ELWI), systemic vascular resistance index(SVRI), global ejection fraction( GEF), and cardiac function index(CFI)before drug use and at 24, 48 and 72 h after drug use in the two groups. Three continuous determination was performed, and average value was obtained. Heart rate(HR), mean arterial pressure(MAP), central venous pressure(CVP), systolic blood pressure(SBP), and diastolic blood pressure(DBP)were recorded at the same time. Results At 24, 48, 72 h after drug use, SBP in the study group was lower than that in the control group(P<0.05), but HR, CVP, MAP, DBP had no significant differences between the two groups(P>0.05). The levels of CFI and ELWI at 24, 48, 72 h after drug use were better than those in the control group(P<0.05). The levels of CI, SVI and CFI in the study group increased- significantly after 24 h of medication compared with medicine use before(P<0.05). The levels of CI and SVI were significantly increased at 72 h after medication, while the level of GEF was increased at 48 after medication in the contol group(P<0.05). After drug use, the levels of GEDI and SVRI were decreased after medication use, but no differences were found after medication use compared with medication use before(P>0.05). Conclusion Recombinant human brain natriuretic peptide can effectively improve cardiac function in heart failure patients with severe sepsis. PICCO technique is an effective and practical method for monitoring blood flow dynamics and blood volume.