Morphological study of cadaveric kidney with focus on relationship of hilum and weight of the kidney

Abstract

Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure.Septic hemodynamic instability imposes challenges to critical care physician in deciding fluid management to optimize preload dependency state.Thirty patients with severe sepsis and hypotension (Mean arterial pressure i.e. MAP < 65 mmHg) and evidence of tissue hypotension i.e. lactate level ≥4 mmol/L were enrolled in our study. Fluid resuscitation (30 ml/kg) was administered. Fluid response was defined as MAP ≥ 65 mmHg with lactate level <4 mmol/L cardiac output (CO), measured by electrical cardiometry, in guiding fluid therapy.The study included 13 males (43.3%) with age 47.8 ± 19.7. Paired comparison showed significant change in MAP readings (P value < 0.001). ROC curve showed cutoff 12.5% for delta CO to predict fluid responsiveness with Area under Curve (AUC) 0.927, sensitivity 90.0%, and specificity 70.0%. ROC also showed delta CO cutoff 12.5% to predict survival with AUC 0.756, sensitivity 66.7% and specificity 66.7%.Delta change in cardiac output, measured by electric cardiometry could be used to predict fluid response and survival in acute circulatory failure in septic critically ill patients.