Volume 21 Issue 7
Jul.  2023
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(7): 1125-1129
GAO Jiaojiao, LI Xiaohong, TAO Jing, DAI Wentao. Application of ultrasound measurement of inferior vena cava collapse index in evaluating pre-anesthesia blood volume in critically ill pregnant women[J]. Chinese Journal of General Practice, 2023, 21(7): 1125-1129. doi: 10.16766/j.cnki.issn.1674-4152.003065
Citation: GAO Jiaojiao, LI Xiaohong, TAO Jing, DAI Wentao. Application of ultrasound measurement of inferior vena cava collapse index in evaluating pre-anesthesia blood volume in critically ill pregnant women[J]. Chinese Journal of General Practice, 2023, 21(7): 1125-1129. doi: 10.16766/j.cnki.issn.1674-4152.003065
shu

Application of ultrasound measurement of inferior vena cava collapse index in evaluating pre-anesthesia blood volume in critically ill pregnant women

doi: 10.16766/j.cnki.issn.1674-4152.003065

  • Department of Anesthesiology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 2020zyrc104

  • Received Date: 2022-08-13
    Available Online: 2023-08-28
    Abstract
  •   Objective  To explore the clinical value of ultrasound measurement of inferior vena cava collapse index (IVC-CI) in critically ill pregnant women for evaluating their pre-anesthesia blood volume.  Methods  A total of 90 critically ill pregnant women who underwent elective cesarean section at the First Affiliated Hospital of Bengbu Medical College from September 2021 to July 2022 were selected and randomly divided into a routine fluid replacement group (C group), a central venous pressure fluid replacement group (CVP group), and an ultrasound measured inferior vena cava fluid replacement group (IVC group), with 30 cases in each group. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), lactate value (Lac), surgical time, bleeding volume, total fluid intake, vasoactive drug use rate, and incidence of postoperative hypotension among three groups of patients at different time points were record and compared. The central venous pressure (CVP), maximum inferior vena cava diameter (dIVCmax), and minimum inferior vena cava diameter (dIVCmin) before and after fluid replacement in the IVC group were record, the IVC-CI was calculated and analyzed its correlation with CVP.  Results  At 5 minutes after anesthesia (T1), after fetal removal (T2), and at the end of surgery (T3), the SBP, DBP, and MAP values in Group C were lower than those in the CVP and IVC groups (P<0.05). At time point T1, the HR and lactate values in Group C were higher than those in the CVP and IVC groups (F=11.650, 7.860, P<0.05). The total liquid intake in Group C [(740.00±156.01)mL] was lower than that in the CVP [(975.00±198.54)mL] and IVC groups [(967.33±179.60)mL, F=16.711, P<0.001]. In the IVC group, dIVCmax and dIVCmin were positively correlated with CVP (r=0.937, 0.873, P<0.05), while IVC-CI was negatively correlated with CVP (r=-0.688, P<0.05).  Conclusion  The inferior vena cava collapse index can be used to evaluate the pre-anesthesia blood volume of critically ill pregnant women and guide fluid replacement.

     

    • FullText(HTML)
  • loading
    • References(22)
  • [1]
    MHIRI R, MVOGO A, KAMGA A, et al. Epidemiology and maternal prognosis of hypertension disorders of pregnancy in French Guiana[J]. Pregnancy Hypertens, 2020, 20(2): 96-101.
    [2]
    牛鹏飞, 张加强, 崔明珠, 等. 下腔静脉塌陷指数与产妇腰麻后仰卧位低血压综合征的相关性[J]. 临床麻醉学杂志, 2020, 36(6): 563-566. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202006012.htm

    NIU P F, ZHANG Q J, CUI M Z, et al. Correlation between inferior vena cava collapse index and supine hypotension syndrome after spinal anesthesia[J]. Journal of Clinical Anesthesiology, 2020, 36(6): 563-566. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202006012.htm
    [3]
    杜唯佳, 徐振东, 刘志强. 剖宫产腰麻后低血压预测方法的研究进展[J]. 临床麻醉学杂志, 2019, 35(2): 192-194. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201902026.htm

    DU W J, XU Z D, LIU Z Q. Research progress on predictive methods of hypotension after spinal anesthesia in cesarean section[J]. Journal of Clinical Anesthesiology, 2019, 35(2): 192-194. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201902026.htm
    [4]
    MOHTA M, DUGGAL S, CHILKOTI G T. Randomised double-blind comparison of bolus phenylephrine or ephedrine for treatment of hypotension in women with pre-eclampsia undergoing caesarean section[J]. Anaesthesia, 2018, 73(7): 839-846. doi: 10.1111/anae.14268
    [5]
    CERUTI S, ANSELMI L, MINOTTI B, et al. Prevention of arterial hypotension after spinal anaesthesia using vena cava ultrasound to guide fluid management[J]. Br J Anaesth, 2018, 120(1): 101-108. doi: 10.1016/j.bja.2017.08.001
    [6]
    徐乐, 赖凤娇, 李向宇. 超声监测下腔静脉参数预测椎管内麻醉后容量状态及容量反应性的价值[J]. 中国临床研究, 2021, 34(5): 600-604, 609. doi: 10.13429/j.cnki.cjcr.2021.05.006

    XU L, LAI F J, LI X Y. Predictive value of inferior vena cava ultrasonography for fluid status and responsiveness after spinal anesthesia[J]. Chinese Journal of Clinical Research, 2021, 34(5): 600-604, 609. doi: 10.13429/j.cnki.cjcr.2021.05.006
    [7]
    NAKAMURA K, TOMIDA M, ANDO T, et al. Cardiac variation of inferior vena cava: new concept in the evaluation of intravascular blood volume[J]. J Med Ultrason, 2013, 40(3): 205-209. doi: 10.1007/s10396-013-0435-6
    [8]
    杨贵亭, 郭向阳, 陶立元, 等. 镇痛/伤害刺激指数与宫腔镜腰麻后低血压的相关性研究[J]. 中国微创外科杂志, 2019, 19(3): 193-196. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWWK201903001.htm

    YANG G T, GUO X Y, TAO L Y, et al. Correlationship between analgesia nociception index and hypotension after spinal anesthesia in patients undergoing hysteroscopic surgery[J]. Chinese Journal of Minimally Invasive Surgery, 2019, 19(3): 193-196. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWWK201903001.htm
    [9]
    DODHY A A. Inferior vena cava collapsibility index and central venous pressure for fluid assessment in the critically ill patient[J]. J Coll Physicians Surg Pak, 2021, 31(11): 1273-1277. doi: 10.29271/jcpsp.2021.11.1273
    [10]
    王骜, 章放香, 彭晶, 等. 围手术期目标导向液体治疗的研究进展[J]. 医学综述, 2021, 27(20): 4058-4062. doi: 10.3969/j.issn.1006-2084.2021.20.018

    WANG A, ZHANG F X, PENG J, et al. Research progress of perioperative goal-directed fluid therapy[J]. Medical Recapitulate, 2021, 27(20): 4058-4062. doi: 10.3969/j.issn.1006-2084.2021.20.018
    [11]
    GARCIA-DE-ACILU M, MESQUIDA J, GRUARTMONER G, et al. Hemodynamic support in septic shock[J]. Curr Opin Anaesthesiol, 2021, 34(2): 99-106. doi: 10.1097/ACO.0000000000000959
    [12]
    潘丽丽, 金孝岠. 每博量变异度和脉压变异度在容量监测中的研究进展[J]. 牡丹江医学院学报, 2020, 41(4): 130-132, 139. https://www.cnki.com.cn/Article/CJFDTOTAL-MDJB202004035.htm

    PAN L L, JIN X J. Research progress of per-wave variation and pulse pressure variation in volume monitoring[J]. Journal of Mudanjiang Medical University, 2020, 41(4): 130-132, 139. https://www.cnki.com.cn/Article/CJFDTOTAL-MDJB202004035.htm
    [13]
    ZIELESKIEWICZ L, NOEL A, DYCLOS G, et al. Can point of care ultrasound predict spinal hypotension during caesarean section? A prospective observational study[J]. Anaesthesia, 2018, 73(1): 15-22. doi: 10.1111/anae.14063
    [14]
    郭敏, 王雷, 雷波, 等. 超声监测下腔静脉直径及其塌陷指数在产后出血容量评估中的应用[J]. 中国医药科学, 2022, 12(9): 161-164. https://www.cnki.com.cn/Article/CJFDTOTAL-GYKX202209041.htm

    GUO M, WANG L, LEI B, et al. Ultrasonic monitoring of inferior vena cava diameter and its collapse index in postpartum hemorrhage volume assessment[J]. China Medicine And Pharmacy, 2012, 12(9): 161-164. https://www.cnki.com.cn/Article/CJFDTOTAL-GYKX202209041.htm
    [15]
    斯妍娜, 鲍红光, 张晨, 等. 下腔静脉塌陷指数的不同阈值指导输液对预防腰麻后低血压的效果[J]. 临床麻醉学杂志, 2018, 34(9): 837-840. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201809001.htm

    SI Y N, BAO H G, ZHANG C, et al. Effects of different thresholds of inferior vena cava ultrasound-guided volume therapy on prevention arterial hypotension after spinal anesthesia[J]. Journal of Clinical Anesthesiology, 2018, 34(9): 837-840. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201809001.htm
    [16]
    CHOWDHURY S R, BAIDYA D K, MAITRA S, et al. Assessment of role of inferior vena cava collapsibility index and variations in carotid artery peak systolic velocity in prediction of post-spinal anaesthesia hypotension in spontaneously breathing patients: an observational study[J]. Indian J Anaesth, 2022, 66(2): 100-106.
    [17]
    高山, 张永. 床边下腔静脉超声指标及中心静脉压对脓毒性休克患者容量反应性的预测价值[J]. 中华全科医学, 2021, 19(4): 581-585. doi: 10.16766/j.cnki.issn.1674-4152.001866

    GAO S, ZHANG Y. The predictive value of variation index of inferior vena cava measured by ultrasonography and central venous pressure in volume responsiveness in patients with septic shock[J]. Chinese Journal of General Practice, 2021, 19(4): 581-585. doi: 10.16766/j.cnki.issn.1674-4152.001866
    [18]
    代里根, 王朝霞. 临床分析超声监测下腔静脉膨胀指数预测全麻患者容量反应[J]. 临床研究, 2020, 28(7): 70-72. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYN202007036.htm

    DAI L G, WANG Z X. Prediction of volume response in patients with general anesthesia by ultrasound monitoring of vena cava inflation index[J]. Clinical Research, 2019, 28(7): 70-72. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYN202007036.htm
    [19]
    DEVI K P, DODDAMANE K P, MANJUNATH H G, et al. Use of inferior venacaval collapsibility index in spinal anesthesia during orthopedic surgeries[J]. Anesth Essays Res, 2021, 15(2): 202-207.
    [20]
    ZHANG H Y, YUAN H M, YU H L. Correlation between pleth variability index and ultrasonic inferior vena cava-collapsibility index in parturients with twin pregnancies undergoing cesarean section under spinal anesthesia[J]. Eur J Med Res, 2022, 27(1): 139.
    [21]
    斯妍娜, 鲍红光, 张晨, 等. 下腔静脉塌陷指数的不同阈值指导输液对预防腰麻后低血压的效果[J]. 临床麻醉学杂志, 2018, 34(9): 837-840. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201809001.htm

    SI Y N, BAO H G, ZHANG C, et al. Effects of different thresholds of inferior vena cava ultrasound-guided volume therapy on prevention arterial hypotension after spinal anesthesia[J]. Journal of Clinical Anesthesiology, 2018, 34(9): 837-840. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201809001.htm
    [22]
    SALAMA E R, ELKASHLAN M. Pre-operative ultrasonographic evaluation of inferior vena cava collapsibility index and caval aorta index as new predictors for hypotension after induction of spinal anaesthesia: a prospective observational study[J]. Eur J Anaesthesiol, 2019, 36(4): 297-302.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(10)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (557) PDF downloads(9) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return