Accuracy of respiratory variation of different vein diameters in predicting fluid responsiveness in patients with septic shock complicated with myocardial injury
10.3760/cma.j.issn.0254-1416.2019.09.028
- VernacularTitle: 不同静脉内径呼吸变异度预测脓毒症休克合并心肌损伤患者容量反应性的准确性
- Author:
Ling LONG
1
;
Haotian ZHAO
2
;
Shan REN
1
;
Limin SHEN
1
Author Information
1. Intensive Care Unit, Hebei General Hospital, Shijiazhuang 050000, China
2. Department of Ultrasound, Hebei General Hospital, Shijiazhuang 050000, China
- Publication Type:Journal Article
- Keywords:
Shock, septic;
Vascular capacitance;
Inferior vena cava;
Jugular veins;
Femoral vein
- From:
Chinese Journal of Anesthesiology
2019;39(9):1135-1138
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the accuracy of trans-xiphoid inferior vena cava diameter variation (v-IVCTX), trans-liver inferior vena cava diameter variation (v-IVCTL), internal jugular vein diameter variation (v-IJV) and femoral vein diameter variation (v-FV) in predicting the fluid responsiveness in the patients with septic shock complicated with myocardial injury.
Methods:Fifty patients with septic shock complicated with myocardial depression admitted to intensive care unit of our hospital, aged ≥18 yr, were selected.The hemodynamics was monitored by PiCCO.Cardiac output (CO) and stroke volume were measured, and v-IVCTX, v-IVCTL, v-IJV and v-FV were measured by ultrasound and then calculated.Fluid replacement test was performed after meeting the standard of fluid resuscitation, and positive fluid responsiveness was defined as increase in CO after volume expansion>10%.Patients were divided into positive fluid responsiveness group and negative fluid responsiveness group.The receiver operating characteristic curve was drawn to evaluate the accuracy of the respiratory variation of each vein diameter in predicting fluid responsiveness.
Results:Compared with negative fluid responsiveness group, v-IVCTX, v-IVCTL and v-IJV were significantly increased (P<0.05), and no significant change was found in v-FV, CO or stroke volume in positive fluid responsiveness group (P>0.05). The cutoff value of v-IVCTX, v-IVCTL and v-IJV in predicting fluid responsiveness was 16.5%, 14.5% and 12%, respectively, the sensitivity was 80%, 76% and 84%, respectively, and the specificity was 72%, 64% and 44%, respectively.The area under the curve (95% confidence interval) of v-IVCTX, v-IVCTL and v-IJV was 0.777 (0.642-0.911), 0.741 (0.605-0.876), and 0.694 (0.549-0.838), respectively.
Conclusion:v-IVCTX and v-IVCTL both can predict the fluid responsiveness in the patients with septic shock complicated with myocardial injury.
