Open AccessRole of Point of Care Ultra Sound (POCUS) in Assessment of Fluid Resuscitation in Septic Patients
Author(s) -
Sohier Fouad,
Nagat Sayed El-Shamaa,
Ghada Fouad Elbaradey,
Hala M. El-Gendy
Publication year - 2021
Publication title -
journal of advances in medicine and medical research
Language(s) - English
Resource type - Journals
ISSN - 2456-8899
DOI - 10.9734/jammr/2021/v33i2031127
Subject(s) - medicine , resuscitation , inferior vena cava , intravascular volume status , central venous pressure , sepsis , cardiac index , amniotic fluid index , mechanical ventilation , sofa score , anesthesia , blood pressure , stroke volume , vital signs , hemodynamics , cardiac output , cardiology , surgery , heart rate , amniotic fluid , pregnancy , fetus , biology , genetics
Background: Initial fluid resuscitation in sepsis must be guided by clinical judgment based on ongoing reevaluation of the hemodynamic status (heart rate, blood pressure, arterial oxygen saturation, respiratory rate, temperature, urine output) and ultrasound measurements (stroke volume, cardiac output, lung ultrasound and inferior vena cava diameter) as positive fluid balance is harmful.
Methods: Adults Patients (≥ 18 years old) with symptoms or signs of tissue hypoperfusion (Sequential organ failure assessment score SOFA≥ 2) are included. Patients with elevated intra-abdominal pressure (as, ascites, pregnancy), Recent abdominal operation, cannot lie flat, Patient on mechanical ventilation and patients with valvular heart disease were excluded. IVC CI, SV, COP and B mean score were measured on patient arrival and after every 10 ml/kg isotonic saline over the first hour of patient arrival. Thereafter, patients were divided into two groups high caval index and low caval index according to inferior vena cava collapsibility index.
Results: Among our 50 patients,38% of patients were with high caval index and 62% have low caval index.
Conclusion: POCUS has additive value in guiding of fluid resuscitation in sepsis in order to avoid fluid overload and to identify proper timing of vasopressor use.