Application Of Ultrasound Dynamic Monitoring Of Inferior Vena Cava Diameter In Guiding The Adjustment Of Dehydration In Patients With Renal Failure And Acute Heart Failure In CRRT

Objective:To explore the application value of bedside ultrasound dynamic monitoring of inferior vena cava diameter and collapse with sniff in guiding the adjustment of dehydration in patients with renal failure and acute heart failure in continuous renal replacement therapy.Methods:We selected 90 patients with renal failure and acute heart failure who required continuous renal replacement therapy in intensive care unit from January 2019 to June2021.According to different blood volume assessment methods,patients were randomly divided into the ultrasound group,the experience group and the control group.The inspection indicators of creatinine,K~+,and NT-pro BNP,the clinical indicators of improvement time of heart failure,time of continuous renal replacement therapy,use time of ventilator,ICU hospitalization time,and use time of vasopressor use and the incidence of adverse event were compared among the three groups.Result:There were no significant differences in creatinine,K~+,and NT-pro BNP between the three groups before and after treatment(P>0.05).The improvement time of heart failure,time of continuous renal replacement therapy,and ICU hospitalization time in ultrasound and experience group were lower than the control group,and the difference between the groups was statistically significant(P<0.05).The use time of ventilator in ultrasound and experience group was lower than the control group,there were statistically significant difference between the ultrasound group and the control group(P<0.05).The use time of vasopressor in the ultrasound group and the control group was lower than the experience group,and the difference between the groups was statistically significant time(P<0.05).The incidence of adverse events in the ultrasound group was lower than the experience group and the control group,and the difference between the groups was statistically significant time(P<0.05).Conclusion:Ultrasound dynamic monitoring of inferior vena cava diameter and collapse with sniff can more accurately assess the blood volume status,and provide a better guidance effect for the accurate dehydration of continuous renal replacement therapy and the rapid relief of heart failure symptoms in patients with renal failure and acute heart failure.