Value of Inferior Vena Cava Respiratory Variation in Assessing Volume Responsiveness in Patients with Septic Shock

Xiaoxue LIU; Meiju LI; Jing XIA

doi:10.12259/j.issn.2095-610X.S20230816

Volume 44 Issue 8

Aug. 2023

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2023 > 44(8): 95-99

Xiaoxue LIU, Meiju LI, Jing XIA. Value of Inferior Vena Cava Respiratory Variation in Assessing Volume Responsiveness in Patients with Septic Shock[J]. Journal of Kunming Medical University, 2023, 44(8): 95-99. doi: 10.12259/j.issn.2095-610X.S20230816

Citation:

Xiaoxue LIU, Meiju LI, Jing XIA. Value of Inferior Vena Cava Respiratory Variation in Assessing Volume Responsiveness in Patients with Septic Shock[J]. Journal of Kunming Medical University, 2023, 44(8): 95-99. doi: 10.12259/j.issn.2095-610X.S20230816

Citation:

PDF( 0 KB)

Value of Inferior Vena Cava Respiratory Variation in Assessing Volume Responsiveness in Patients with Septic Shock

doi: 10.12259/j.issn.2095-610X.S20230816

Dept. of Emergency Medicine，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2023-05-13
Available Online: 2023-09-12
Publish Date: 2023-08-30

Abstract

Abstract

Objective To explore inferior vena cava respiratory variation assessing volume responsiveness in patients with septic shock. Methods A total of 60 patients with septic shock in the Emergency Department of the First Affiliated hospital of a medical university from August 2018 to May 2019 were selected. According to the different guidance methods of fluid resuscitation, they were divided into the Variance of Inferior Vena Cava （VIVC） guided fluid resuscitation group A and Central Venous Pressure （CVP） guided fluid resuscitation in group B. Stroke volume （SV） was evaluated by ultrasound before and 30min, 1h, 3h and 6h after fluid infusion. Lactate （Lac）, brain natriuretic peptide （BNP）, base excess （BE） and heart rate （HR） , respiratory rate （RR）, central venous oxygen saturation （SCVO2）, mean arterial pressure （ MAP） and urine volume were recorded at the above time points in both groups and were compared. Results MAP, SCVO2, and urine volume increased, while RR decreased in the same group at different time points with the progress of fluid infusion （P < 0.05）. However, there was no significant difference in MAP, RR, SCVO2 and urine volume between the two groups （P > 0.05）. After stopping resuscitation, BNP increased and HR decreased in the two groups, and BNP and HR in group B were higher than those in group A （P < 0.05）. Lac decreased and BE increased in the two groups, but there was no significant difference between the two groups （P > 0.05）. Conclusion Compared with CVP, IVC variability is equally valuable in evaluating fluid responsiveness in patients with septic shock, and it is safer because it causes less BNP elevation and avoids fluid overload.
- Variance of inferior vena cava,
- Central venous pressure,
- Septic shock,
- Fluid resuscitation

FullText(HTML)

References(16)

References

[1]	Singer M, Deutschman C S, Seymour C W, et al. The third international consensus definitions for sepsis and septic shock （Sepsis-3） [J]. JAMA, 315（8）: 801-810.
[2]	Monnet X, Lai C, Teboul J L. How I personalize fluid therapy in septic shock?[J] Crit Care, 2023 , 27（1）: 123.
[3]	Casserly B,Read R,Levy M M. Hemodynamic monitoring in sepsis[J]. Crit Care Clin,2009,25(4):803-823. doi: 10.1016/j.ccc.2009.08.006
[4]	Marik P E,Cavallazzi R. Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some commonsense[J]. Crit Care Med,2013,41(7):1774-1781. doi: 10.1097/CCM.0b013e31828a25fd
[5]	Chong Y,Yu Y,Zhao Y,et al. Value of inferior vena cava diameter and inferior vena cava collapse index in the evaluation of peripartum volume: A prospective cohort study[J]. Eur J Obstet Gynecol Reprod Bio,2023,285:69-73.
[6]	Singer M,Deutschman C S,Seymour C W,et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)[J]. JAMA,2016,315(8):801-810.
[7]	Rivers E P,Kruse J A,Jacobsen G,et al. The influence of early hemodynamic optimization on biomarker patterns of severe sepsis and septic shock[J]. Crit Care Med,2007,35(9):2016-2024. doi: 10.1097/01.CCM.0000281637.08984.6E
[8]	Zhao J,Wang G. Inferior vena cava collapsibility index is a valuable and non-invasive index for elevated general heart end-diastolic volume index estimation in septic shock patients[J]. Med Sci Monit,2016,22:3843-3848. doi: 10.12659/MSM.897406
[9]	De Valk S,Olgers T J,Holman M,et al. The caval index:An adequate non-invasive ultrasound parameter to predict fluid responsiveness in the emergency department?[J]. BMC Anesthesiol,2014,4:114.
[10]	Kim D W,Chung S,Kang W S,et al. Diagnostic accuracy of ultrasonographic respiratory variation in the Inferior vena cava,subclavian vein,internal jugular vein,and femoral vein diameter to predict fluid responsiveness: A systematic review and meta-analysis[J]. Diagnostics (Basel),2021,12(1):49. doi: 10.3390/diagnostics12010049
[11]	Xiong Z,Zhang G,Zhou Q,et al. Predictive value of the respiratory variation in inferior vena cava diameter for ventilated children with septic shock[J]. Front Pediatr,2022,10:895651.
[12]	王君生. PICCO和超声评估脓毒性休克容量反应性的研究[D]. 郑州: 郑州大学, 2017.
[13]	黄伟,万献尧. 2013版严重全身性感染和感染性休克处理指南解读[J]. 中国实用内科杂志,2013,33(11):866-868.
[14]	Osman D,Ridel C,Ray P,et al. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge[J]. Crit Care Med,2007,35(1):64-68. doi: 10.1097/01.CCM.0000249851.94101.4F
[15]	Cecconi M,De Backer D,Antonelli M,et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine[J]. Intensive Care Med,2014,40(12):1795-1815. doi: 10.1007/s00134-014-3525-z
[16]	Marik P E,Baram M,Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares[J]. Chest,2008,134(1):172-178. doi: 10.1378/chest.07-2331

Relative Articles(20)

Relative Articles

[1]	Jiashuo Chang, Zhengyong Zha, Guangsi Zou, Xianli Huang, Qiuyan Su, Zhenggan Gao. Application of Different Inferior Vena Cava Filters Placed in the Renal Vein for Endovascular Treatment of Deep Venous Thrombosis. Journal of Kunming Medical University, 2024, 46(): 1-8.
[2]	Bo PENG, Gang SU, Rong QIN, Rong WEN, Wei YIN. Observation of Achieving Controlled Low Central Venous Pressure with Goal-directed Fluid Therapy Combined with Milrinone in Laparoscopic Hepatic Lobectomy. Journal of Kunming Medical University, 2024, 45(9): 116-121. doi: 10.12259/j.issn.2095-610X.S20240918
[3]	Mengxia Tang, Linkun Ta, Yanling Huang, Yongping Lu, Xiangbi Li, Jiafeng Yang. Prenatal Ultrasound Observation of Persistent Left Superior Vena Cava with Intracardiac Malformation. Journal of Kunming Medical University, 2023, 44(8): 100-104. doi: 10.12259/j.issn.2095-610X.S20230827
[4]	Hongyin ZHANG, Hongmei ZHU, Huiqin ZHANG, Hongwen YAO, Guirong ZHU, Lin LI. Investigation on Occupational Exposure and Protection of Cytotoxic Drugs among PIVAS Personnel in Yunnan Province. Journal of Kunming Medical University, 2023, 44(7): 105-112. doi: 10.12259/j.issn.2095-610X.S20230722
[5]	Libo ZHU, Yanhua XU, Jinfen LI, Xue HU, Chunyan LU, Kun LU, Liuyan DUAN, Huanyi LI. Clinical Application of Ultrasound-guided Peripherally Inserted Central Venous Catheter in Neonates with Vascular Access Difficulties. Journal of Kunming Medical University, 2023, 44(4): 117-122. doi: 10.12259/j.issn.2095-610X.S20230415
[6]	Qiang WANG, Dexing YANG, Weiyu ZHOU, Jiefu TANG, Kai FU, Zhenfang WANG, Shengzhe LIU, Min LI, Ying LUAN, Rong LIU. Analysis of Prognostic Risk Factors in Patients with Septic Shock Based on Circulatory and Cellular Immune Response Indicators. Journal of Kunming Medical University, 2023, 44(7): 78-87. doi: 10.12259/j.issn.2095-610X.S20230716
[7]	Wensong DING, Qicai QU, Hong LI, Liu YANG, Jianping TAO, Yongyu SI. Effects of Different Fluids on Microcirculation and Inflammatory Factors in Rabbits with Hemorrhagic Shock. Journal of Kunming Medical University, 2023, 44(12): 13-19. doi: 10.12259/j.issn.2095-610X.S20231202
[8]	Yu WU, De-xing YANG, Hong WANG, Qiang WANG, Wei-yu ZHOU, Jie-fu TANG, Zhen-fang YANG, Kai FU, Rong LIU. The Relationship between Arterial and Venous Blood Lactic Acid in Early Stage of Septic Shock and Prognostic Value of Lactate and Lactate Clearance Rate. Journal of Kunming Medical University, 2021, 42(9): 83-89. doi: 10.12259/j.issn.2095-610X.S20210927
[9]	Zhang Ai Ling . Conventional Segmentation and Large Fractionated Three-dimensional Conformal Radiotherapy in the Treatment of Non Small Cell Lung Cancer with Superior Vena Cava Syndrome. Journal of Kunming Medical University,
[10]	Wei Wei , Li Yan , Zhang Ying , Wang YunXi , Zhang Su , Yang Cong . Effects of Highly Concentrated Potassium Chloride via Central Venous Catheterization on Severe Hypokalemia. Journal of Kunming Medical University, 2016, 37(11): 113-115.
[11]	Fu Juan Juan . . Journal of Kunming Medical University,
[12]	Sun Hai Mei . . Journal of Kunming Medical University,
[13]	Zhang Jian Hua . . Journal of Kunming Medical University,
[14]	Tao Jian Ping . . Journal of Kunming Medical University,
[15]	Yang De Xing . . Journal of Kunming Medical University,
[16]	Wang Xiao . . Journal of Kunming Medical University,
[17]	Liu Li Shan . . Journal of Kunming Medical University,
[18]	Cai Hong Bo . . Journal of Kunming Medical University,
[19]	. Replacement of Superior Vena Cava in the Treatment of Chest Tumor. Journal of Kunming Medical University,
[20]	. Cause Analysis and Strategies of Catheter-related Infections in Peripherally Inserted Central Catheter. Journal of Kunming Medical University,