Acil Serviste Yatak Başı Ultrasonografi ile Vena Kava Inferior Çapı Ölçümü ve Santral Venöz Basınç Ölçümünün İlişkilendirilmesi
Özet
Sepsis syndromes are usually diagnosed in the Emergency Department. Early and effective treatment of these syndromes is extremely important, since they may result in significant rates of mortality. The main part of the treatment is fluid resuscitation. At this point the problem is monitorization intravascular volume status. Measurement of Inferior Vena Cava diameter is an alternative to invasive procedures that guidelines recommend for monitoring fluid resuscitation. The study was performed as a prospective and observational study between April 2014-October 2014. Emergency Department patients with sepsis diagnose and who had central venous catheter on internal jugular or subclavian vein as a part of treatment plan, were involved the study. The patients’ IVC diameters were measured with ultrasonography twice in 3 hours along with Central Venous Pressure (CVP). The measurements were performed with a convex transducer; the right atrial entry of IVC was spotted, and 2 cm distal to this point the IVC diameter was measured on M-mode. The vital signs, lactate and pH values were recorded simultaneously. We performed 44 Inferior Vena Cava Collapsibility Index (IVC-CI)/CVP pairs from 22 patients. Mean age was 71.7 (42-92) and 59.1 % were female. 28 days mortality was 59.1% and total mortality was 68%. Mean CVP was 5.6 mmHg at zero hour, 6.8 mmHg at 3.hour and mean IVC-CI was calculated 0.31 at zero hour and 0.26 at 3.hour. We found 64 % correlation between ΔCVP and ΔIVC-CI (p<0.01); 58% correlation between ΔCVP and Δ IVC inspiratory (p<0.01); 92 % correlation between ΔIVC-CI and Δ IVC inspiratory (p<0.01) using Pearson correlation test.
