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肾前性急性肾衰竭液体治疗中灌注指数与下腔静脉塌陷指数的随访

Follow-up of perfusion index and inferior vena cava collapsibility index in fluid therapy in prerenal acute renal failure.

作者信息

Koc Güdük Nihal, Sahin Taner

机构信息

Sorgun State Hospital, Yozgat, Turkey.

Emergency Medicine Department Kayseri City Training and Research Hospital Affiliated with University of Health Sciences Turkey, Kayseri, Turkey.

出版信息

Heliyon. 2023 Jul 27;9(8):e18715. doi: 10.1016/j.heliyon.2023.e18715. eCollection 2023 Aug.

Abstract

INTRODUCTION

Acute renal failure (ARF), which may occur as a result of hypovolemia, is frequently diagnosed in emergency departments. It is essential to determine these patients' volume status and fluid requirement. The aim of this study was to examine the change in the inferior vena cava (IVC) collapsibility index and perfusion index (PI) in order to evaluate fluid deficit, volume status, and response to fluid therapy in patients with prerenal ARF who presented with signs of hypovolemia.

MATERIALS AND METHODS

The study sample included 104 patients diagnosed with prerenal ARF due to hypovolemia in our emergency department. After obtaining informed consent from the patients, intravenous (IV) fluid therapy (20 cc/kg IV infusion of 0.9% sodium chloride solution for 30 min) was initiated. The PI and IVC collapsibility index were measured before and after the treatment.

RESULTS

Of the patients included in this study, 56.7% were women. The mean age was 76.06 years. Of the patients, 46.2% had a history of multiple diseases. Avoidant/restrictive food intake disorder was the most common complaint (28.8%). The mean PI of the patients was 2.20 at admission, which increased to 3.27 after treatment. The mean IVC collapsibility index was 38.39 at admission, which decreased to 29.36 after treatment. There was a significant and negative correlation between the PI and IVC collapsibility index of the patients.

CONCLUSIONS

Early diagnosis and treatment of ARF in emergency departments are critical. Serial measurements of the IVC collapsibility index and PI are helpful in monitoring patients' response to fluid therapy.

摘要

引言

急性肾衰竭(ARF)可能因血容量不足而发生,在急诊科经常被诊断出来。确定这些患者的容量状态和液体需求量至关重要。本研究的目的是检查下腔静脉(IVC)塌陷指数和灌注指数(PI)的变化,以评估出现血容量不足体征的肾前性ARF患者的液体缺失、容量状态及对液体治疗的反应。

材料与方法

研究样本包括104例在我院急诊科因血容量不足被诊断为肾前性ARF的患者。在获得患者知情同意后,开始静脉(IV)液体治疗(以20 cc/kg的剂量静脉输注0.9%氯化钠溶液30分钟)。在治疗前后测量PI和IVC塌陷指数。

结果

本研究纳入的患者中,56.7%为女性。平均年龄为76.06岁。患者中,46.2%有多种疾病史。回避/限制食物摄入障碍是最常见的主诉(28.8%)。患者入院时的平均PI为2.20,治疗后升至3.27。入院时平均IVC塌陷指数为38.39,治疗后降至29.36。患者的PI与IVC塌陷指数之间存在显著负相关。

结论

急诊科对ARF进行早期诊断和治疗至关重要。连续测量IVC塌陷指数和PI有助于监测患者对液体治疗的反应。

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