Andruszkiewicz Paweł, Sobczyk Dorota, Nycz Krzysztof, Górkiewicz-Kot Izabela, Ziętkiewicz Mirosław, Wierzbicki Karol, Wojtczak Jacek, Kowalik Ilona
2 Department of Anaesthesiology and Intensive Care, Warsaw Medical University, Warsaw, Poland.
Emergency and Admission Department, John Paul II Hospital, Cracow, Poland.
J Ultrason. 2017 Dec;17(71):241-245. doi: 10.15557/JoU.2017.0035. Epub 2017 Dec 29.
Ultrasound measurement of the inferior vena cava diameter and its respiratory variability are amongst the predictors of fluid volume status. The primary purpose of the present study was to compare the consistency of inferior vena cava diameter measurements and the collapsibility index, obtained with convex and cardiac transducers. A secondary aim was to assess the agreement of the patient's allocation to one of the two groups: "fluid responder" or "fluid non-responder", based on inferior vena cava collapsibility index calculation made with two different probes.
20 experienced clinicians blinded to the purpose of the study analysed forty anonymized digital clips of images obtained during ultrasound examination of 20 patients. For each patient, one digital loop was recorded with a cardiac and the second with a convex probe. The participants were asked to determine the maximal and minimal diameters of the inferior vena cava in all presented films. An independent researcher performed a comparative analysis of the measurements conducted with both probes by all participants. The calculation of the collapsibility index and allocation to "fluid responder" or "fluid non-responder" group was performed at this stage of the study.
The comparison of measurements obtained with cardiac and convex probes showed no statistically significant differences in the measurements of the maximal and minimal dimensions and in the collapsibility index. We also noticed that the decision of allocation to the "fluid responder" or "non-responder" group was not probe-dependent.
Both transducers can be used interchangeably for the estimation of the studied dimensions.
超声测量下腔静脉直径及其呼吸变异度是评估血容量状态的指标之一。本研究的主要目的是比较使用凸阵探头和心脏探头测量下腔静脉直径的一致性以及塌陷指数。次要目的是基于用两种不同探头计算的下腔静脉塌陷指数,评估将患者分配到“液体反应者”或“液体无反应者”两组之一的一致性。
20名对研究目的不知情的经验丰富的临床医生分析了20例患者超声检查期间获取的40段匿名数字图像片段。对于每位患者,用心脏探头记录一个数字环路,用凸阵探头记录第二个数字环路。要求参与者确定所有呈现影片中下腔静脉的最大和最小直径。一名独立研究人员对所有参与者用两种探头进行的测量进行了比较分析。在研究的这个阶段进行塌陷指数的计算以及分配到“液体反应者”或“液体无反应者”组。
心脏探头和凸阵探头测量结果的比较显示,最大和最小尺寸的测量以及塌陷指数在统计学上无显著差异。我们还注意到,分配到“液体反应者”或“无反应者”组的决定不依赖于探头。
两种探头均可互换使用以估计所研究的尺寸。