Department of Emergency Medicine, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey.
Department of Emergency Medicine, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey.
Acta Cardiol. 2021 May;76(3):245-257. doi: 10.1080/00015385.2020.1740422. Epub 2020 Mar 19.
The primary aim of this study was to determine the value of the inferior vena cava (IVC) ultrasound in the decision to hospitalise acute decompensated heart failure (ADHF) patients. Our secondary aim was to find the most successful IVC measurement method in monitoring volume status.
ADHF patients were accepted over a 1-year period in this study. Patients' vital signs, laboratory tests and IVC measurements measured by six methods (in B- and M-mode; maximum, minimum diameter and caval index) performed on an hourly basis were recorded. The presence of any statistically significant difference between the IVC measurement methods, laboratory tests and vital parameters between the hospitalised and discharged patients was calculated. ROC curves were produced in order to determine the ability of parameters to differentiate two groups. Spearman's correlation test was used to investigate correlation between the IVC measurement methods and patients' urine outputs.
A total of 71 patients were included in the study; 42 of these were hospitalised and 29 were discharged. Potassium, brain natriuretic peptide, respiration rate, urine output, maximum and minimum IVC diameters differed significantly between the two groups. Minimum IVC diameter measured in M-mode was identified as a weak marker with 65% sensitivity and 64% specificity (+PPV: 73%; -NPV:54%) for hospitalisation. Change in maximum IVC diameter measured in B-mode exhibited a high degree of correlation with change in body fluid (cc: 0.802).
IVC ultrasound may have a limited value in the decision to hospitalise ADHF patients. But Maximum IVC diameter may be an ideal method for monitoring hypervolemic patients' volume status.
NCT02725151.
本研究的主要目的是确定下腔静脉（IVC）超声在决定急性失代偿性心力衰竭（ADHF）患者住院治疗中的价值。我们的次要目的是找到监测容量状态最成功的 IVC 测量方法。
在这项研究中，在一年内接受了 ADHF 患者。记录患者的生命体征、实验室检查和每小时进行的 6 种方法（B 型和 M 型；最大、最小直径和腔静脉指数）测量的 IVC。计算住院和出院患者之间 IVC 测量方法、实验室检查和生命参数之间是否存在任何统计学显著差异。为了确定参数区分两组的能力，生成了 ROC 曲线。Spearman 相关检验用于研究 IVC 测量方法与患者尿量之间的相关性。
共有 71 名患者纳入研究；其中 42 名住院，29 名出院。两组间钾、脑钠肽、呼吸频率、尿量、最大和最小 IVC 直径差异有统计学意义。M 型测量的最小 IVC 直径被确定为一种弱标志物，具有 65%的敏感性和 64%的特异性（+PPV：73%；-NPV：54%）用于住院治疗。B 型测量的最大 IVC 直径的变化与体液变化高度相关（cc：0.802）。
IVC 超声在决定 ADHF 患者住院治疗方面的价值可能有限。但最大 IVC 直径可能是监测高血容量患者容量状态的理想方法。
NCT02725151。
