[Clinical evaluation of transthoracic echocardiography predicting fluid responsiveness in septic shock].

作者：Jingyi Wu, Xia Zhang, Zhen Wang, Biaohu Liu, Xiaogan Jiang, Weihua Lu, Xiaoju Jin, Xiaoting Wang · 发表于：PubMed · 年份：2014 · DOI：10.3760/cma.j.issn.2095-4352.2014.01.008 · 被引用次数：2 · 研究领域：Hemodynamic Monitoring and Therapy、Sepsis Diagnosis and Treatment、Ultrasound in Clinical Applications

OBJECTIVE: To evaluate clinical value of transthoracic echocardiography (TTE) predicting fluid responsiveness in patients with severe sepsis or septic shock, the parameters of pulse indicator continuous cardiac output (PiCCO) system was combined. METHODS: Twenty-eight severe sepsis or septic shock patients with mechanically ventilated in intensive care unit (ICU) of Wannan Medical College Yijishan Hospital were prospectively observed from March 2011 to December 2012. The hemodynamic parameters including stoke volume (SV), cardiac output (CO), cardiac output index (CI) and the distensibility index of the inferior vena cava (dIVC), descending aortic blood flow (ABF) were measured by PiCCO and/or TTE in the supine position. Responders were defined by the appearance of an increase in SV (ΔSV)≥10% after liquid loading. The value of TTE predicting fluid responsiveness was evaluated in severe sepsis or septic shock patients. RESULTS: There were a total of 53 times liquid loading test in 28 patients, of which with 30 times was positive. The area under receiver operating characteristic curve (ROC curve, AUC) for dIVC predicting fluid responsiveness was 0.887, the dIVC threshold value of 22.5% had the sensitivity of 83.3% and specificity of 82.6% for prediction of fluid responsiveness. The AUC for ABF predicting fluid responsiveness was 0.794, the ABF variation threshold value of 10.95% had the sensitivity of 86.7% and specificity of 73.9% for prediction of fluid responsiveness. The AU...