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| Effects of respiratory variation index of the inferior vena cava internal diameter on acute kidney injury caused by septic shock |
| CHENG Tao, ZHANG Xiao - xia, PENG Peng, YUSUFUJIANG, YANG Jian - zhong, AIKEBAIER, LI Wen - chao, XIAO Bei - bei, QIAO Ming - ming |
| Department of Emergency Medicine, the First Teaching Hospital of Xinjiang Medical University, Wulumuqi 830000, China |
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Abstract Objective To explore the effects of respiratory variation index of the inferior vena cava internal diameter ( ΔIVC) on acute renal injury ( AKI) caused by septic shock in emergency intensive care unit ( EICU). Method A retrospective study of 62 patients who were diagnosed with septic shock in EICU of The First Teaching Hospital of Xinjiang Medical University from October 1st 2013 to February 31st 2015 and the ΔIVC were respectively monitored by bedside ultrasound at the beginning and 24 hour after fluid resuscitation was performed. The cases were assigned into low ΔIVC group (ΔIVC < 20% ,n = 32), or high ΔIVC group (ΔIVC≥20% ,n = 30) according to the ΔIVC of 24hour after fluid resuscitation. The hemodynamic data, APACHE Ⅱ score, serum creatinine, lactate concentration were performed respectively at the beginning and 24 hour after fluid resuscitation. The incidence and mortality of AKI, the outcome of these patients in EICU and at Day 28 post - diagnosis were recorded. Results There were 25 cases (78. 1% ) in low ΔIVC group attacked with AKI, while 16 cases (53. 3% ) in high ΔIVC group were attacked with AKI, the incidence of AKI in low ΔIVC group was significantly higher than that in the high ΔIVC group. A total of 23 patients (37. 1% ) died in EICU, include 16 cases (50. 0% ) in low ΔIVC group and 7 cases (23. 3% ) in high ΔIVC group and 18 cases(56. 3% ) died at Day 28 post - diagnosis in low ΔIVC group while 11 cases(36. 7% ) in high ΔIVC group. The emergency intensive care unit mortality in low ΔIVC group was significantly higher than that in the high ΔIVC group, but 28 - day mortality there was no statistical difference. Conclusions A low ΔIVC group may increase and mortality of AKI after septic shock, therefore low ΔIVC should be avoided in clinical treatment.
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Received: 15 June 2015
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Corresponding Authors:
PENG Peng, E - mail: pengpeng4949@ 126. com
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