Value of cardiac ultrasound combined with respiratory variability index of interior vena cava in assessment of volume responsiveness of septic shock patients
OBJECTIVE To explore the value of cardiac ultrasound combined with respiratory variability index of in-terior vena cava(IVC-RV)in assessment of volume responsiveness of the patients with septic shock.METHODS A total of 102 patients with septic shock who were treated in Longyou Branch,Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from Oct 2020 to Oct 2023 were recruited as the research subjects and were divided into the volume responsiveness group and the no volume responsiveness group according to the result of volume load test.The baseline data was compared between the two groups.The IVC-RVI,cardiac output(CO),aortic time velocity integral(VTI)and cardiac index(CI)were observed and compared before and after volume expansion.The influencing factors for the volume responsiveness of the septic shock patients were ana-lyzed,and the values of the above indexes in assessment of volume responsiveness were analyzed by means of re-ceiver operating characteristic(ROC)curves.RESULTS There were 54(52.94％)cases in the volume responsive-ness group and 48(47.06％)cases in the no volume responsiveness group.The N-terminal pro-B-type natriuretic peptide(NT-proBNP)level of the volume responsiveness group was lower than that of the no volume responsive-ness group(P＜0.05);the IVC-RVI level of the volume responsiveness group was higher than that of the no vol-ume responsiveness group before the volume expansion(P＜0.05),while the levels of CO and VTI of the volume responsiveness group were lower than those of the no volume responsiveness group(P＜0.05);the CI of the vol-ume responsiveness group was higher than that of the no volume responsiveness group after the volume expansion(P＜0.05).The IVC-RVI was the risk factor for the volume responsiveness of the septic shock patients before the volume expansion,while the CO,VTI and CI were the protective factors(P＜0.05).ROC curve analysis showed that the areas under curves(AUCs)of the single and joint detection of IVC-RVI,CO,VTI and CI were all more than 0.60,and the joint detection was the best(P＜0.05).CONCLUSION The patients without volume responsive-ness are dominant among the septic shock patients,and it is necessary for the hospital to carry out the test of vol-ume responsiveness by ultrasound combined with IVC-RV.
Septic shockVolume responsivenessUltrasoundRespiratory variability index of interior vena cavaAortic time velocity integralCardiac index
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