Killu Keith, Coba Victor, Blyden Dionne, Munie Semeret, Dereczyk Darlene, Kandagatla Pridvi, Tang Amy
Department of Surgery, Division of Acute Care Surgery, Henry Ford Hospital, Detroit, MI, USA.
Keck School of Medicine, Department of Medicine, Division of Pulmonary, Critical Care, Sleep Medicine, University of Southern California, Los Angeles, CA, USA.
Crit Care Res Pract. 2020 Feb 24;2020:9719751. doi: 10.1155/2020/9719751. eCollection 2020.
The objective of the study was to use an ultrasound-based numerical scoring system for assessment of intravascular fluid estimate (SAFE) and test its validity.
A prospective, observational study was carried out in the surgical intensive care unit (ICU) of an urban tertiary care teaching hospital. Patient's intravascular volume status was assessed using the standard methods of heart rate, blood pressure, central venous pressure, cardiac output, lactate and saturation of venous oxygen, and others. This was compared with assessment using bedside ultrasound evaluation of the cardiac function, inferior vena cava, lungs, and the internal jugular vein. Applying a numerical scoring system was evaluated by Fisher's exact testing and multinomial logistic model to predict the volume status based on ultrasound scores and the classification accuracy.
61 patients in the ICU were evaluated. 21 (34.4% of total) patients diagnosed with hypovolemia, and their ultrasound volume score was -4 in 14 (66.7%) patients, -3 in 5 (23.8%) patients, and 0 in 2 (9.5%) patients ( < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient ( < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient ( < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient ( < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient (.
Using the SAFE scoring system to identify the IVV status in critically ill patients significantly correlates with the standard measures. A SAFE score of -4 to -2 more likely represents hypovolemia, -1 to +1 more likely represents euvolemia, and +2 to +4 more likely to be hypervolemia.
本研究的目的是使用基于超声的数值评分系统评估血管内液体量估计（SAFE）并测试其有效性。
在一家城市三级护理教学医院的外科重症监护病房（ICU）进行了一项前瞻性观察研究。使用心率、血压、中心静脉压、心输出量、乳酸和静脉血氧饱和度等标准方法评估患者的血管内容量状态。将其与使用床边超声评估心脏功能、下腔静脉、肺部和颈内静脉的结果进行比较。通过Fisher精确检验和多项逻辑模型评估应用数值评分系统，以根据超声评分预测容量状态和分类准确性。
对ICU中的61例患者进行了评估。21例（占总数的34.4%）患者被诊断为低血容量，其中14例（66.7%）患者的超声容量评分为-4，5例（23.8%）患者为-3，2例（9.5%）患者为0（<0.001）。18例（占总数的29.5%）患者被诊断为血容量正常，其中11例（61.1%）患者的超声容量评分为0，4例（22.2%）患者为+1，1例（5.6%）患者为-1（<0.001）。18例（占总数的29.5%）患者被诊断为血容量正常，其中11例（61.1%）患者的超声容量评分为0，4例（22.2%）患者为+1，1例（5.6%）患者为-1（<0.001）。18例（占总数的29.5%）患者被诊断为血容量正常，其中11例（61.1%）患者的超声容量评分为0，4例（22.2%）患者为+1，1例（5.6%）患者为-1（<0.001）。18例（占总数的29.5%）患者被诊断为血容量正常，其中11例（61.1%）患者的超声容量评分为0，4例（22.2%）患者为+1，1例（5.6%）患者为-1（。
使用SAFE评分系统识别危重症患者的血管内液体量状态与标准测量方法显著相关。SAFE评分为-4至-2更可能代表低血容量，-1至+1更可能代表血容量正常，+2至+4更可能代表高血容量。
