Acil Servisteki Şok Hastalarında Yatak Başı Ultrasonografi Aracılığıyla Karotis Doppler Akım Hızı Ölçümü ile Volüm Değerlendirilmesi ve Vena Kava İnferior Çapı Ölçümünün Santral Venöz Basınç ile İlişkilendirilmesi

Abstract

Kaymakcı R. Volume Assessment by Carotid Doppler Flow Rate Point of care Ultrasonography and Vena Cava Inferior Diameter Measurement in Associating with Central Venous Pressure in Emergency Department. Hacettepe University Faculty of Medicine, Thesis of Emergency Medicine, Ankara 2020. Early diagnosis and initiation of treatment in the emergency department before the shock is irreversible is of great importance in terms of reducing mortality. Fluid resusicitation in the first line threatment. Many techniques are used for volume assessment: In our study, we evaluated the volume of carotis doppler flow rate (CDFR) in shock patients by POCUS, which is a fast, accessible and noninvasive technique; the aim of this study was to investigate the correlation between VCICI, VCI diameter and CVP also mortality prediction of these values were quastioned. This prospective and observational study was conducted with 51 patients with shock in the emergency department. CDFR, VCI measurements, VCICI and CVP measurements were performed by POCUS. Patients were followed up until they reached any outcome (death, discharge, referral). 55% of the patients were male and 45% were female. The mean age of the patients was 67 years. Malignancy was detected in 45% of patients. 88% of the patients were diagnosed as septic shock. Mortality rate was 57%. The median value of CDFR was calculated as 48 cm/sec. It was determined that the mortality of the patients could be predicted with the results of CDFR, VCICI, CVP. It was determined that the mortality of the patients could be predicted with the results of CDFR, VKİK, CVP. Correlations were found between CVP, VCICI, VCI diameter, and CDFR. The cut-off value was calculated as 50 cm/sec in the ROC curve for CDFR and the sensitivity and specificity were 72% and 68% respectively. CVP’s cut-off value of 1.5 mmH20 with 61% sensitivity and 71% specificity. The cut-off value for VCICI was calculated to be 54.5% with 93% sensitivity and 85% specificity. As a result, it was concluded that the parameters of CDFR, CVP and VCICI may be useful clinician ideas for the evaluation of volume status and predicting mortality in shock patients.