Study Of Correlation Between Inferior Vena Cava Diameters And Volume Responsiveness

Objective To observe the hemodynamic parameters of volume-response in patients with septic shock by bedside ultrasound,and analyze the hemodynamic parameters with respiration according to the changes of stroke volume and pulse pressure before and after the fluid replacement test and the tidal impact test.The change value and its prediction of the patient’s capacity reactivity,and then explore the application value of ultrasound hemodynamics index to determine the patient’s capacity response.The method was adopted in the intensive care unit of our hospital from January to February 18,2017.Forty-eight patients with mechanically ventilated septic shock were enrolled in the study.The selected patients were considered to have capacity expansion tests under the conditions of expansion indication,which met the inclusion and exclusion criteria.According to the presence or absence of response after the fluid replacement test,the selected patients were divided into observation group(with response group)in 28 cases and control group(no reaction group)in 20 cases.The selected patients were subjected to a fluid replacement test and a tidal volume impact test.The central venous pressure(CVP),inferior vena cava diameter(IVCD),variability per volume(SVV),and pulse variability(PPV)were measured before and after the test.After the hemodynamic indicators,the indicators were analyzed immediately and the obtained data were collected.All the ultrasound data were measured 3 times and averaged.Statistical analysis was performed using SPSS17.0 software,and the measurement data were expressed as mean ± standard deviation.The chi-square test was used to compare the count data;the paired t test was used for comparison within the group;the independent sample t test was used for comparison between groups;the Pearson correlation analysis was used for the correlation analysis.The gender,age,BMI,tidal volume(TV)between the observation group and the control group.There was no significant difference in respiratory rate(RR)and left ventricular ejection fraction(LVEF)(p>0.05),indicating that the comparison between the observation group and the control group was comparable.Control group: Compared with before the test,PPV and SVV decreased,IVCmax and IVCmin increased slightly after the test,but the differencewas not statistically significant(p>0.05).Observation group: After the test,PPV and SVV decreased,IVCmax and IVCmin increased significantly after the test,and the difference was statistically significant(p<0.05).Comparison between the two groups:The baseline values ??of PPV and SVV in the observation group before rehydration were significantly higher than those in the control group,and IVCmax and IVCmin were significantly lower than the control group,and the difference was statistically significant(p<0.05).The hemodynamic parameters IVCmax,IVCmin,and SVV,PPV were significantly positively correlated with the pre-fluid test and tidal volume impact test.The difference was statistically significant(P<0.05),while CVP and SVV,PPV were not significant.Correlation(P>0.05),the difference was not statistically significant(P>0.05).Conclusions The values ??of hemodynamic parameters such as IVCD and CVP measured by bedside ultrasound in patients with septic shock were higher in the reactive group than in the non-responsive group.The IVC of bedside ultrasound in patients with septic shock in the reactive group The hemodynamic parameters such as CVP were reduced after the capacity load test;IVCD was significantly correlated with SVV and PPV before the volume load test,and can be used to accurately evaluate the volume reactivity of patients with septic shock;ultrasonic measurement of the diameter of the inferior vena cava The changes have important clinical value in judging the volume reactivity of patients with septic shock.