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通过超声测量下腔静脉和主动脉直径评估院前环境中的容量状态。

Evaluation of volume status in a prehospital setting by ultrasonographic measurement of inferior vena cava and aorta diameters.

作者信息

Ragaisyte Egle, Bardauskiene Lina, Zelbiene Egle, Darginavicius Linas, Zemaityte Elzbieta, Jasinskas Nedas, Stasaitis Kestutis

机构信息

Lithuanian University of Health Sciences, Department of Emergency Medicine, Kaunas, Lithuania.

出版信息

Turk J Emerg Med. 2018 Sep 7;18(4):152-157. doi: 10.1016/j.tjem.2018.07.002. eCollection 2018 Dec.

Abstract

OBJECTIVES

The aim of this study was to evaluate the utility of ultrasonographic measurement of the diameter of the inferior vena cava (IVCD) and abdominal aorta (AAD) for assessing volume status.

MATERIAL AND METHODS

This was a prospective, observational study. A total of 23 volunteers participated in the study. Each participant was selected randomly. All participants completed the 2016 Kaunas Marathon. Participants filed out a brief survey about their fluid intake (in standardised glasses) in the 24 h before the race and during the race. Participants underwent ultrasound measurements 10-40 min before the start of the race and 3-15 min after finishing the race. To visualize respiratory variation, M-mode was used, with the beam crossing the IVCD 2 cm from the right atrium. The AAD was measured 1 cm above the celiac trunk. IVCD in expiration (IVCDexp)/AAD was calculated by dividing the value of IVCDexp by the value of AAD. The findings were compared with difference in body mass index.

RESULTS

The mean weight lost after the marathon was 2.93 kg ( < 0.001). Mean IVCD in inspiration (IVCDins) after the run was lower by 0.39 cm ( < 0.001) then before the run. Mean IVCDexp/AAD after the run was 0.24 cm lower than before the run ( = 0.03). Before and after the marathon, there was a statistically significant negative correlation in weight difference, with mean IVCDexp difference ( = 0.047). There was no statistically significant difference in caval index before and after running.

CONCLUSION

Ultrasonographic assessment of IVCDexp could be useful in the evaluation of volume status.

摘要

目的

本研究旨在评估超声测量下腔静脉直径(IVCD)和腹主动脉直径(AAD)对评估容量状态的实用性。

材料与方法

这是一项前瞻性观察性研究。共有23名志愿者参与了该研究。每个参与者均为随机选取。所有参与者均完成了2016年考纳斯马拉松比赛。参与者填写了一份关于他们在比赛前24小时及比赛期间液体摄入量(以标准杯为单位)的简短调查问卷。参与者在比赛开始前10 - 40分钟和比赛结束后3 - 15分钟接受超声测量。为观察呼吸变化,采用M型超声,声束在距右心房2 cm处穿过下腔静脉。在腹腔干上方1 cm处测量腹主动脉直径。呼气时下腔静脉直径(IVCDexp)/腹主动脉直径通过将IVCDexp值除以AAD值计算得出。将研究结果与体重指数差异进行比较。

结果

马拉松赛后平均体重减轻2.93 kg(<0.001)。跑步后吸气时下腔静脉平均直径(IVCDins)比跑步前降低了0.39 cm(<0.001)。跑步后平均IVCDexp/AAD比跑步前降低了0.24 cm(=0.03)。马拉松前后,体重差异与平均IVCDexp差异之间存在统计学上的显著负相关(=0.047)。跑步前后腔静脉指数无统计学上的显著差异。

结论

超声评估IVCDexp可能有助于评估容量状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b63/6261101/e8cb00129744/gr1.jpg

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