The use of hemodynamic ultrasound in the management of blood volume in elderly patients with acute heart failure
10.3760/cma.j.issn.0254-9026.2023.12.012
- VernacularTitle:超声血流动力学在老年急性心力衰竭患者容量管理中的运用
- Author:
Li SHENG
1
;
Min ZHAO
;
Longhuan ZENG
Author Information
1. 杭州市第一人民医院城北院区超声科，杭州 310022
- Keywords:
Heart failure;
Ultrasonography;
Volume management
- From:
Chinese Journal of Geriatrics
2023;42(12):1458-1463
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To use hemodynamic ultrasound to monitor the blood volume of elderly patients with acute heart failure(AHF)and to assess the outcome of clinical treatment.Methods:In this retrospective analysis, elderly patients with AHF treated at our hospital between June 2020 and June 2022 were divided into two groups, with 32 in Group A assessed by ultrasound for volume overload and given timely treatment where appropriate and 32 in Group B assessed by physicians for volume overload using clinical parameters and given timely treatment where appropriate.Differences in the time required to ascertain volume overload between assessment based on ultrasound and assessment based on clinical parameters were compared.Additionally, differences in values of patients' vital sign parameters, laboratory tests and hemodynamic ultrasound parameters after 48-hour treatment since the diagnosis of AHF were also analyzed.Results:The time required for ultrasound diagnosis of volume overload in Group A was significantly shorter than in Group B, and the difference between the two groups was statistically significant[(1.08±0.34)h vs.(9.21±2.57)h, t=-17.722, P<0.05]. After 48 hours of treatment, the heart rate and respiratory rate(RR)in Group A were significantly lower than those in Group B[(87.87±4.38)times/min, (20.78±2.28)times/min vs.(94.78±6.53)times/min, (24.15±2.02)times/min, respectively, P<0.05]. The brain natriuretic peptide(BNP)in Group A was significantly lower than that in Group B[(1122.00±132.07)ng/L vs.(1301.13±217.94)ng/L, P<0.05]; In Group A, parameters such as the ultrasound hemodynamic index E/e'(15.69±2.79), inferior vena cava(IVC)diameter(1.77±0.16)cm, lung ultrasound score(LUS)(11.03±1.15)points vs.(12.13±1.70)points showed statistically significant differences, compared with group B( P<0.05). Logistic regression analysis showed RR( OR=1.650, 95% CI: 1.104-2.466, P=0.015), E/e'( OR=1.631, 95% CI: 1.065-2.498, P=0.024), and IVC( OR=1.714, 95% CI: 1.250-2.349, P=0.001)were independent predictors for the assessment of volume overload. Conclusions:Hemodynamic ultrasound can be used to assess the early volume status of elderly patients with AHF, serve as an evidence-based tool for guiding early clinical volume management, and should be recommended in clinical practice.
