The Value Of The Variation Of Inferior Vena Cava In The Assessment Of Volume Responsiveness In Patients With Septic Shock

Objective:Long-term clinical use of central venous pressure(cvp),pulse indicator continous cardiac output(picco),pulmonary artery catheter(pac),etc.for hemodynamic monitoring of critically ill patients,but the cause inaccurate and invasive,itsapplication is limited.Some related studies have shown that there is a positive correlation between the diameter of the inferior vena cava and cvp,and the inverse vena cava has a negative correlation with cvp.This study is intended to explore the inferior cavity.The value of venous variability in guiding the assessment of the capacity of patients with septic shock.Methods:This study was a prospective,open-label,single-center,randomized,controlled trial of 36 patients with septic shock in the Dpartment of Energency Medicine,Fist Afiliated Hospital of Kunming Medica University,based on inferior vena cava respiratory variability(vivc)and central vein pressure(cvp)guidance.The fluid resuscitation of the enrolled patients was divided into VIVC-guided patients with fluid resuscitation group A.Group A was mechanical ventilation A1 group and spontaneous respiration A2 group;CVP was used to guide patients with fluid resuscitation group B.The rehydration of the two groups was recorded for 0min,30min,1h,3h,6h stroke volume(SV),lactate(Lac),B-type natriuretic peptide(BNP),base excess(BE),heart rate(HR),respiration rate(RR),central venous oxygen saturation(SCVo2),mean artetial pressure(MAP),hourly urine volume and 2-week and 4-week survival rates were compared and compared.Results:There was no significant difference in age,gender,infection site and APECHII score between group A and B(P>0.05).The variance analysis of repeated date,A1,A2,B groups 0min,30min,lh,3h,6h,the main body effect test Lac,BE,HR,RR,SCVo2,MAP,BNP,hourly urine volume improvement difference was statistically significant(p<0.001),SV changes no difference statistically significant,patients with Lac,BE,HR and RR were significantly reduced after fluid resuscitation,and SCVo2,MAP,BNP and urine per hour were significantly increased;further LSD-t comparisons were made,Al and B group,There were significant differences in BNP and HR between group A2 and group B(p<0.05).There was no significant difference in Lac,BE,HR,MAP,RR,SCVo2,hourly urine volume,survival rate of 2 weeks and 4 weeks.Compared with CVP,VIVC showed a more significant reduction in HR after guiding patients with fluid resuscitation,and BNP did not increase significantly.Conclusion:1.Compared with CVP,VIVC guided volume response assessment in patients with septic shock.there was no significant increase in BNP and significant decrease in HR after fluid therapy.2.Compared with CVP,VIVC evaluated volume responsiveness is safer in patients with septic shock.