Role Of Lung Ultrasound , CVP And Inferior Vena Cava Diameter And Collapsibility Index In Assessment Of End Point Of Fluid Therapy In Critically ILL Patient With Sepsis | ||
| Benha Journal of Applied Sciences | ||
| Article 5, Volume 7, Issue 10, October 2022, Pages 33-40 PDF (604.29 K) | ||
| Document Type: Original Research Papers | ||
| DOI: 10.21608/bjas.2022.284646 | ||
| Authors | ||
| S.I. Saad; A.S. Behairymb; E.W. Mahdy | ||
| Anathesia & Intensive care, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||
| Abstract | ||
| Severe physiological and biochemical abnormalities provide a significant risk of death in the clinic, making sepsis a potentially fatal illness. Sepsis is now defined as "organ dysfunction induced by a dysregulated host response to infection," under the Third International Consensus (Sepsis-3). Our research aimed to determine the best methods for determining whether a critically sick patient with sepsis had reached the end of fluid treatment by comparing the results of lung ultrasonography, central venous pressure, and IVC diameter and collapsibility index. Methods: Fortyfive patients from the intensive care unit at Banha university hospital participated in the cohort research. Results: At admission, this research found that hypovolemia was linked to lower CVP, lower dIVC max and lower dIVCmin, and greater IVC CI, but that there was no significant difference between hypo and euvolemia in LUSS. Over the course of 120 minutes, CVP, dIVC max, dIVC min, LUSS, and IVCCI all rise gradually, whereas IVCCI falls gradually over the first 30 minutes. The AUCs for predicting hypervolemia using IVC CI and LUSS were moderate. The current investigation demonstrated a robust positive link between CVP, LUSS, and dIVCmin/max following fluid consumption over time, and a substantial negative correlation between IVCCI and these same variables. Prediction of hypervolemia for the purpose of discontinuing fluid infusion was thought to be possible with a lower IVC-CI and a greater LUSS. In conclusion, assessing the endpoint of fluid treatment in patients with hypovolemic shock due to sepsis is made more easier and more accurate using lung ultrasound due to its noninvasive nature and high sensitivity and specificity. Prediction of hypervolemia for the purpose of discontinuing fluid resuscitation in septic patients was shown to be best accomplished by a combination of a lower IVC-CI and a higher LUSS. Evaluation of the collapsibility index of the inferior vena cava provides a low-risk, high-sensitivity alternative to monitoring central venous pressure. A low CVP was shown to be an unreliable indicator of fluid responsiveness. | ||
| Keywords | ||
| Lung Ultrasound - CVP - Inferior Vena Cava Diameter - Collapsibility Index - End Point - Fluid Therapy - Critically ILL Patient; Sepsis | ||
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