Volume 19 Issue 4
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GAO Shan, ZHANG Yong. The predictive value of variation index of inferior vena cava measured by ultrasonography and central venous pressure in volume responsiveness in patients with septic shock[J]. Chinese Journal of General Practice, 2021, 19(4): 581-585. doi: 10.16766/j.cnki.issn.1674-4152.001866
Citation: GAO Shan, ZHANG Yong. The predictive value of variation index of inferior vena cava measured by ultrasonography and central venous pressure in volume responsiveness in patients with septic shock[J]. Chinese Journal of General Practice, 2021, 19(4): 581-585. doi: 10.16766/j.cnki.issn.1674-4152.001866
shu

The predictive value of variation index of inferior vena cava measured by ultrasonography and central venous pressure in volume responsiveness in patients with septic shock

doi: 10.16766/j.cnki.issn.1674-4152.001866

  • Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 1804h08020287

  • Received Date: 2020-11-21
    Available Online: 2022-02-16
    Abstract
  •   Objective  To compare the predictive value of inferior vena cava ultrasound indicators and central venous pressure (CVP) as predictors of fluid of responsiveness in patients who experienced septic shock.  Methods  Twenty-seven patients who experienced septic shock were enrolled in the study. The diameter of inferior vena cava (d-IVC) and its variation with respiration (v-IVC), CVP measured by bedside ultrasound, arterial blood lactate level and cardiac index (CI) were collected at hospitalisation and after resuscitation. The fluid resuscitation was performed as follows: All patients were administered with 7 mL/kg lactated Ringer's solution (ideal body weight) within 20 min. Fluid responsiveness was defined as ΔCI≥15% after resuscitation (responding group or R group, n=19; the rest was classified as nonresponding group or NR group, n=8). The accuracy of predicting volume responsiveness was evaluated by plotting the receiver operating characteristic (ROC) curve on the basis of the measured indicators before resuscitation.  Results  Compared with the NR group, the R group had a low d-IVCmin, d-IVCmax and a significantly high v-IVC before resuscitation (P < 0.05). However, no significant difference was observed in lactate level of arterial blood, CVP before resuscitation (P > 0.05). The optimal cut-off value of v-IVC was 17.65%. The sensitivity and specificity of the predictive value of volume responsiveness in patient who experienced septic shock were 100.0% and 87.5%, respectively. The area under the ROC curve of v-IVC for predicting volume responsiveness was 0.924 (95% CI: 0.781-1.000).  Conclusion  The predictive value of v-IVC in the volume responsiveness of patients who experienced septic shock is high, and the predictive value is higher when v-IVC >17.65%.

     

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