THE CORRELATION BETWEEN INFERIOR VENA CAVA DIAMETER MEASURED BY ULTRASONOGRAPHY AND CENTRAL VENOUS PRESSURE VALUE IN PATIENTS WITH SHOCK
Main Article Content
Abstract
Background: Shock is a serious hemodynamic disorder that is common in patients with life-threatening conditions, requiring a rapid fluid status assessment to guide treatment. In addition to central venous pressure (CVP), ultrasonographic measurement of inferior vena cava (IVC) diameter is a non-invasive method of fluid status that is useful in shock patients. Objectives: To evaluate the IVC diameters and CVP indexes, and to investigate the correlation between the diameter of the IVC on ultrasound and the CVP in patients with shock. Materials and methods: A descriptive cross-sectional study on 53 shock patients from March 2020 to March 2021 at the Intensive Care Unit of Can Tho Central General Hospital. Results: There were 84.9% patients on mechanical ventilation. 49.1% of patients had CVP greater than 12cmH2O, 15.1% less than 8cmH2O. Mean CVP =13.6±6.21cmH2O. The average of maximal diameter of the IVC was 17.0±3.92mm, the minimum was 13.8±4.70mm. The mean IVC collapsibility index (CI-IVCD%) was 20.2±15.73%. The index of largest, smallest and average IVC diameter were positively correlated with CVP, p<0.001. The CI-IVCD% was negatively correlated with CVP, p=0.008. The CI-IVCD% had the highest value to predict CVP levels below 8 cmH2O among the indices of the IVC on ultrasound, with AUC=0.836; p<0.003. Conclusion: The IVC diameter measured by ultrasound has a good correlation with CVP, in which the CI-IVCD% has the best value to predict hypovolemia.
Article Details
Keywords
shock, CVP, inferior vena cava diameter, IVCD
References
2. Phạm Ngọc Kiếu, Nguyễn Huỳnh Bích Phượng và Hồ Thanh Nhân (2016), "Tương quan giữa đường kính tĩnh mạch chủ dưới đo bằng siêu âm với áp lực tĩnh mạch trung tâm", Kỷ yếu Hội nghị Khoa học Bệnh viện An Giang (10/2016), tr. 1-8.
3. Lê Văn Tuấn và Nguyễn Anh Vũ (2018), "Nghiên cứu đường kính tĩnh mạch chủ dưới trên siêu âm và áp lực tĩnh mạch trung tâm ở bệnh nhân sốc", Tạp chí Y Dược học - Trường Đại học Y Dược Huế. 8(2).
4. Aydin, SA et al. (2015), "Is there a relationship between the diameter of the inferior vena cava and hemodynamic parameters in critically ill patients?", Nigerian journal of clinical practice. 18(6), pp. 810-813.
5. Barbier, Christophe et al. (2004), "Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients", Intensive care medicine. 30(9), pp. 1740-1746.
6. De Backer, Daniel và Vincent, Jean-Louis %J Critical Care (2018), "Should we measure the central venous pressure to guide fluid management? Ten answers to 10 questions", Critical Care. 22(1), pp. 1-6.
7. Khalil, Amir, Khan, Aslam và Hayat, Arshad %J Pakistan Armed Forces Medical Journal (2015), "Correlation of inferior vena cava (IVC) diameter and central venous pressure (CVP) for fluid monitoring in ICU", Pakistan Armed Forces Medical Journal. 65(2), pp. 235-238.
8. Kislitsina, Olga N et al. (2019), "Shock–Classification and Pathophysiological Principles of Therapeutics", Current cardiology reviews. 15(2), pp. 102-113.
9. Levitov, Alexander et al. (2016), "Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients—part II: cardiac ultrasonography", Critical care medicine. 44(6), pp. 1206-1227.
10. Thanakitcharu, Prasert, Charoenwut, Marisa và Siriwiwatanakul, Napha %J J Med Assoc Thai (2013), "Inferior vena cava diameter and collapsibility index: a practical non-invasive evaluation of intravascular fluid volume in critically-ill patients", J Med Assoc Thai. 96(Suppl 3), pp. S14-22.
11. Worapratya, Panita et al. (2014), "Correlation of caval index, inferior vena cava diameter, and central venous pressure in shock patients in the emergency room", Open access emergency medicine: OAEM. 6, pp. 57.