Correlation of radius and respiration variation of inferior vena cava with central venous pressure in elderly patiens with septic shock / 中华老年医学杂志

ABSTRACT

Objective To explore the correlation of the radius and respiratory variation of inferior vena cava(IVC)with central venous pressure(CVP)for rapid evaluation of blood volume with ultrasound in elderly patients with septic shock.Methods The radius of IVC was measured using bedside ultrasound,respiration variation index(RVI)was calculated as followingRVI =(maximum radius-minimum radius)/maximum radius × 100％ and central venous pressure(CVP)was also recorded in 28 elderly patients with septic shock before and during 2 h and 6 h fluid recovery.Radius and RVI of IVC were compared between 28 shock patients and 22 healthy volunteers as control.Correlation of radius and RVI of IVC with CVP were analyzed.The thresholds of radius and RVI of IVC to estimate CVP 8 mmHg were determined by Receiver Operator Characteristic Curve (ROC)curves.Results The maximum and minimum radius[(1.23±0.28)cm and(0.48±0.18)cm]in the elderly patients with septic shock were smaller than in control group[(1.95±0.14)cm and (1.73±0.13)cm].RVI in the elderly patients with septic shock were larger than in control group [(55.88±11.18)％ vs.(11.23± 1.82)％].The maximum and minimum radius were positively(r=0.668 and 0.863,both P＜0.01)and RVI negatively(r=-0.848,P＜0.01)with CVP.The thresholds of maximum radius,minimum radius and RVI of IVC to estimate CVP 8 mmHg were 1.56cm(sensitivity 85.2％,specificity 86.3％),1.13 cm(sensitivity 96.3％,specificity 94.1％)and 30％(sensitivity 88.2％,specificity 96.3％),respectively.Conclusions Using ultrasound to measure radius of IVC and calculate RVI might estimate CVP to certain degree.It might be an option for physicians to rapidly estimate blood volume in the elderly patients with septic shock.