ABSTRACT
We aimed to present inferior vena cava [IVC] diameter as a guiding method for detection of relationship between IVC diameter measured noninvasively with the help of ultrasonography [USG] and central venous pressure [CVP] and evaluation of patient's intravascular volume status. Patients over the age of 18, to whom a central venous catheter was inserted to their subclavian vein or internal jugular vein were included in our study. IVC diameter measurements were recorded in millimeters following measurement by the same clinician with the help of USG both at the end-inspiratory and end-expiratory phase. CVP measurements were viewed on the monitor by means of piezoelectric transducer and recorded in mmHg. SPSS 18.0 package program was used for statistical analysis of data. Forty five patients were included in the study. The patients had the diagnosis of malignancy [35.6%], sepsis [13.3%], pneumonia, asthma, chronic obstructive pulmonary disease [11.1%]. 11 patients [24.4%] required mechanical ventilation while 34 [75.6%] patients had spontaneous respiration. In patients with spontaneous respiration, a significant relationship was found between IVC diameters measured by ultrasonography at the end of expiratory and inspiratory phases and measured CVP values at the same phases [for expiratory p = 0.002, for inspiratory p= 0.001]. There was no statistically significant association between IVC diameters measured by ultrasonography at the end of expiration and inspiration and measured CVP values at the same phases in mechanically ventilated patients. IVC diameter measured by bedside ultrasonography can be used for determination of the intravascular volume status of the patients with spontaneous respiration
ABSTRACT
Background: In literature, electrocardiographic (ECG) changes and the increase in the levels of the natriuretic peptide are shown to occur in patients having acute ischemic stroke. We aimed to investigate the association between ECG alterations and NT pro B-type natriuretic peptide (NT-proBNP) values in patients having acute ischemic stroke with no known cardiac pathology. Methods: The patients who admitted to the emergency service with acute ischemic stroke were enrolled in the study. Their ECGs were recorded and serum samples were obtained as soon as they arrived into the emergency service. The plasma NT-proBNP levels were measured by electrochemiluminescence method. Maximum QT interval, QT dispersion (QTd), corrected QT and corrected QTd (cQT and cQTd) was calculated, for each ECG. The patients were evaluated according to the Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS). Results: A total of 50 consecutive patients were evaluated. QT intervals for 4 patients (8%) and cQT intervals for 29 patients (58%) were above 440 ms and 11 patients (22%) had QTd values above 50ms and 17 (34%) had cQTd values above 50 ms. The NTproBNP levels had a negative correlation with the GCS (p=0.001, r= -0.461) and a positive correlation with the NIHSS, cQT, QTd and cQTd (p=0.001, r=0.444, p=0.000, r=0.494, p=0.016, r=0.338 p=0.011, r=0.355, respectively). Conclusions: The NT-proBNP levels in the ischemic stroke patients with no known cardiac pathology were markedly increased, and this increase was found to be associated with the GCS, NIHSS, cQT, QTd and the cQTd interval.