ASSESSMENT OF INFERIOR VENA CAVA DIAMETER MEASURED BY ULTRA-SONOGRAPHY IN CORRELATION WITH CENTRAL VENOUS PRESSURE VALUE IN PATIENTS WITH SEPSIS

Abstract

Background: Bedside ultrasound is potentially a useful noninvasive adjunct to estimate the intravascular volume status in sepsis. Aim of the work: Evaluating the correlation between inferior vena cava diameter measured non-invasively with ultrasonography versus central venous pressure in assessment of intravascular volume status in patients with sepsis.Patients and methods: The study was conducted on sixty patients with sepsis (30 ventilated and 30 non-ventilated) in the Respiratory Intensive Care Unit at Abbassia Chest Hospital from January 2018 to September 2018. For all included patients demographic data were collected Recording vital sings, mean arterial pressure and Pao2/ Fio2were done. Laboratory investigation including complete blood count, serum lactic acid, arterial blood gas, quantitative C-reactiveprotein were also done. Sequential Organ Failure Assessment score (SOFA), Qsofa and Acute Physiology And Chronic Health Evaluation II score (APACHE II) were recorded. Finally measurement of IVC, CVP and intra-abdominal pressure were done Results: Males represent 75%while female were 25%withmean age of (47.40±14.49) years. The mean CVP was 12.48±3.78 cmH2O with an IVC maximum diameter of 17.95±3.28 mm and collapsibility index of 50.55±11.83 %. There was statistically significant positive correlation between CVP and IVC dmax and statistically significant negativecorrelation between CVP and IVC CI (%)in both ventilated and non ventilated groups. Also, CVP and IVC dmax were significantly correlated with outcome in both ventilated and non ventilated patients. The higher values of CVP and IVC dmax and the lower the value of IVC CI, the higher rates of mortality. Conclusion: US assessment of IVC diameter and caval index are simple and non invasive methods to assess intravascular volume status.