Effectiveness Of IVC Monitoring By Bedside Ultrasound In Early Diagnosis Of Patients With Traumatic Shock

Objective To explore the effectiveness of inferior vena cava(IVC)diameter in early diagnosis of patients with traumatic shock,and to provide reference for bedside ultrasound monitoring of patients with traumatic shock.Methods A prospective cohort study was conducted in 88 patients with traumatic shock who visited the first affiliated hospital of Shihezi University from September 2019 to December2020.The control group received 50 healthy people for physical examination.The patients were divided into stable group(S group)and unstable group(NS Group)according to whether there was shock after treatment in emergency department.General information of patients in study group and control group was collected and recorded respectively,before and after treatment,blood pressure(BP),mean arterial pressure(MAP),heart rate(HR),shock index(Si),lactic acid(LAC),alkali residue(BE),IVCmax and IVCmin,RVI,Stroke volume and CI were measured in both groups.The changes of indexes before and after treatment and the differences between the two groups were compared.The receiver operating characteristic curve(ROC)and the area under the curve(AUC)were used to determine the predictive significance of each index.Conclusion There were 53 patients in S group and 35 patients in NS Group.Before treatment,the HR,SBP,DBP,Si,MAP,Lac,BE,CI of the two groups were not significantly different(P > 0.05);RVI of NS Group was larger than s group,IVCmax and IVCmin were smaller than s group,the difference was statistically significant(p < 0.05).There were significant differences in HR,SBP,DBP,Si and MAP between the two groups after treatment(p < 0.05),Lac,RVI,CI,BE,IVCmax and IVCmin in NS group were significantly higher than those in s group(p < 0.05)Lac,RVI,HR and SI in group S decreased after treatment,IVCmax,IVCmin,MAP,BE,CI,SBP and DBP increased after treatment(p < 0.05)HR,SBP,MAP,LAC,BE,Si and DBP in NS Group decreased after treatment,but SI and DBP increased after treatment,and there was no significant difference(P > 0.05).IVCmax,IVCmin,CI,RVI decreased after treatment,the difference was statistically significant(p < 0.05).There was no correlation between HR,SBP,DBP,Si,MAP,Lac,BE and δ CI(P > 0.05),negative correlation between IVCmax,IVCmin and δCI(p < 0.05),positive correlation between RVI and δCI(p < 0.05).The area under ROC curve(AUC)was 0.797,the optimal critical value was 39.2%,the sensitivity was 73.9%,and the specificity was 73.3%.RVI combined LAC prediction(AUC)was 0.815,RVI combined BE prediction(AUC)was 0.807.