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| Relationship between diameter variation of inferior vena cava and arterial lactate clearance in patients with infective shock |
| Chen Xi, Tian Suo-chen, Xu Zhi-ping, Wang Qiang, Wu Tie-jun |
| Department of Critical Care Medicine, Liaocheng People's Hospital, Liaocheng 252000, China |
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Abstract Objective To discuss the relationship between the diameter variation of inferior vena cava (△IVCD) and the arterial lactate clearance during early fluid resuscitation in patients with infective shock. Methods Fifty-four patients with infective shock who were treated with mechanical ventilation from March 2016 to March 2018 were selected, and according to the early goal directed therapy, all patients were given fluid resuscitation at 6 hours Bundle. Then they were divided into the reaching standard group (39 cases) and the non-reaching standard group (15 cases) according to whether or not they reached the standard. All patients were recorded the general condition, the diameter variation of inferior vena cava, the level of lactic acid in arterial blood before the fluid resuscitation; Meanwhile, the diameter of inferior vena cava and level of lactic acid in arterial blood were monitored after 6 hours of fluid resuscitation. Finally, the data of monitoring were statistically analyzed. Results After the fluid resuscitation, the diameter variation of the inferior vena cava in the standard group was significantly lower than that in the non-standard group (%：24.43±6.11 vs. 30.44±5.42,P<0.05),and the arterial lactate clearance was significantly higher than that in the non-standard group (%：21.72±14.77 vs. 9.64±7.40，P< 0.05). The diameter variation of inferior vena cava was significantly negatively correlated with the arterial lactate clearance in standard group (P<0.05). When the diameter of the inferior vena cava was used to determine whether the fluid resuscitation in the patients with infective shock reached the standard, the area under the curve was 0.827, the critical value was 25.66%, the sensitivity was 93.3%, and the specificity was 71.2%. When the arterial lactate clearance was used to determine whether the fluid resuscitation in the patients with infective shock reached the standard, the area under the curve was 0.765, the critical value was 18.36%, the sensitivity was 73.3%, and the specificity was 76.9%. Conclusion For patients with infective shock, after 6 hours Bundle fluid resuscitation according to the EGDT regimen, the diameter of the inferior vena cava in the standard group was lower, the arterial lactate clearance was higher, and there is a significant negative correlation between both of them. The sensitivity of the inferior vena cava diameter which is used to judge whether the fluid resuscitation is up to the standard is more sensitive.
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Corresponding Authors:
Wu Tie-jun, E-mail: tiejunwu@hotmail.com
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