Naslov
Reliability of lung ultrasound and inferior vena cava collapsibility index in volume status estimation in ICU patients during early postoperative period

Autori
Karaman Ilic, Maja ; Sakic, Livija

Izvornik
Critical care (1466-609X) 21 (2017), 1; 51-51

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
lung ultrasound, inferior vena cava collapsibility, volume, ICU

Sažetak
Introduction: A liberal approach to volume replacement therapy is commonly seen during surgical procedures. An excess of administrated fluid may result in an increase of Extra Vascular Lung Water (EVLW) and can cause gas exchange deterioration. The aim of this study was to investigate whether Lung Ultrasound, a noninvasive bedside method, can be used in volume status estimation. Methods: Sixty patients without known cardiac or pulmonary diseases admitted to the Intensive care Unit (ICU) after elective abdominal or vascular surgical procedure, were included in the study sample. Inferior Vena Cava collapsibility index (IVC cl) and PaO2/FiO2 ratio were measured and the occurrence of B-lines was monitored at the patients’ admission to the ICU (0 time), and after six, twelve and twenty-four hours. The appearance of B- lines < =7 mm together with IVC cl > = of 40% was taken as a sign of fluid overload and the rise of Extra Vascular Lung Water (EVLW). The value of the PaO2/FiO2 ratio lower than 200 was a sign of tissue oxygenation impairment. Results: In 18/60(30%) of patients there were no signs of fluid overload. In 42/60(70%) of patients fluid overload was detected. The comparison of the appearance of B-lines < = 7 mm coupled with IVCcl > =40% to PaO2/FiO2 < 200 showed no difference in the time when fluid overload was detected (Wilcoxon test, P = 0.0113). Relations between individual measures (B-Lines vs PaO2/FiO2 and IVCcl vs PaO2/FiO2) that were tested at the given times, showed a statistically significant association between B lines and PaO2/FiO2(Chi- square test, P < 0.001 for all four times of measurement). The relation between IVCcl and PaO2/FiO2 was not statistically significant (Chi-square test, P = 0.071 or higher for all). Conclusions: Our study showed that Lung Ultrasound had the same sensitivity as the PaO2/FiO2 ratio in the detection of fluid overload, and that Lung Ultrasound could be used for EVLW detection in the ICU patients during early postoperative period. These findings should be further verified in studies involving larger samples. References 1. Lichtenstein DA. BLUE-protocol and FALLS- protocol: two applications of lungultrasound in the critically ill. Chest. 2015 Jun ; 147: 1659–70. 2. Bouhemad, M Zhang, Q Lu, JJ Rouby. Clinical review: bedside lung ultrasound in critical care practice. Crit Care 2007 ; 11: 205

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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