Evaluation of ultrasonography measurement of superior vena cava diameter in comparison to central venous pressure in guiding of fluid therapy in patients with hypovolemic shock | ||
| Benha Journal of Applied Sciences | ||
| Article 7, Volume 7, Issue 10, October 2022, Pages 47-54 PDF (377.25 K) | ||
| Document Type: Original Research Papers | ||
| DOI: 10.21608/bjas.2022.288238 | ||
| Authors | ||
| G.M. Mahmoud1; E.S. Abdelazeem2; D.H. Elbarbary2 | ||
| 1Critical Care, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||
| 2Intensive care and Anasetheia, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||
| Abstract | ||
| Invasive placement of a central venous catheter is the norm for measuring central venous pressure (CVP), which is essential in perioperative care (CVC). Clinical evaluation of the jugular venous pressure allows for a non-invasive estimation of CVP. Superior vena cava (SVC) diameter and collapsibility with breathing have been emphasised in echocardiographic estimates of CVP. The goal of this study is to compare CVP values to ultrasound measurements of SVC diameter and collapsibility index in directing fluid treatment for patients with hypovolemic shock. On admission, patients underwent hemodynamic monitoring of intravascular volume by measuring central venous pressure, taking a non-invasive blood pressure reading, and calculating urine output. Additionally, SVC ultrasonography was used to determine the diameter and collapsibility of the saphenous vein. Conclusions Patients with a central venous pressure (CVP) of 10 or higher had substantially greater values for their SVC maximum and minimum, and smaller values for their SVC coefficient of variation (CI). There was a positive association between CVP and maximum and minimum dSVC, and a negative correlation between CVP and SVC-CI. The optimal SVC-CI cutoff for separating patients with and without CVP10 was 36%, with a sensitivity of 27% and a specificity of 87.5 %. Independent predictors of CVP10 were shown to be lower SVC-CI, which aided in the decision to discontinue fluid infusion. Overall, the CVP is still the gold standard for guiding fluid resuscitation in the critically unwell. Estimating CVP non-invasively by measuring SVC diameter and collapsibility during positive pressure breathing seems intriguing. Predicting high CVP using SVC-CI might help you decide when to stop giving the patient fluids. | ||
| Keywords | ||
| Shock; hypovolemia; CVP; SVC; shock monitoring | ||
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