Unit:
Κατεύθυνση ΑναζωογόνησηLibrary of the School of Health Sciences
Author:
Trigkidis Kyriakos
Supervisors info:
Θεόδωρος Ξάνθος, Καθηγητής, Σχολή Επιστημών Υγείας, ΠΑΔΑ
Κωνσταντίνος Εκμεκτζόγλου, Επίκουρος Καθηγητής, Ιατρική Σχολή, Ευρωπαικό Πανεπιστήμιο Κύπρου
Νικολέττα Ιακωβίδου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Συσχέτιση υπερηχογραφικών δεικτών φλεβικής συμφόρησης με την ενδοκοιλιακή πίεση ασθενών νοσηλευόμενων στη Μονάδα Εντατικής Θεραπείας
Translated title:
Correlation of ultrasonography indices of venous congestion with intra-abdominal pressure in Intensive Care Unit patients
Summary:
Intra-abdominal hypertension is common in critically ill patients and although associated with increased morbidity and mortality, it is often under-diagnosed. Lately, the use of point-of-care ultrasound techniques for assessing fluid overload in intra-abdominal organs has gained pace, the most studied amongst them being the Venous Excess Ultrasound (VExUS) score. The potential association of VExUS score with intra-abdominal hypertension has not as of yet been investigated.
A prospective observational study was conducted in a general Intensive Care Unit (ICU) in order to examine differences between patients with normal and elevated intra-abdominal pressure, regarding the VExUS score values during the first 72 hours of ICU stay.
A total of 96 mechanically ventilated patients were included in the study; 60.4% were male, median age was 62 years and median Sequential Organ Failure Assessment (SOFA) score was 9. 53.5% of the patients had normal intra-abdominal pressure values, while 27.1% had stage I and 17.7% stage II abdominal hypertension. VExUS score values were 0 in 22.9% and 1 in 50% of included patients.
Between patients with normal and elevated intra-abdominal pressure there was no statistically significant difference with regard to VExUS score values (p =0.997). In a sub-analysis, a statistically significant but weak correlation was found between intra-abdominal pressure and the values of the flow pattern in the interlobar renal veins, the latter being a component of VExUS score (Spearman’s correlation, Rho = 0.26, 95% confidence interval 0.06 - 0.44). Multivariate analysis demonstrated that intra-abdominal pressure is independently associated with the flow pattern in the interlobar renal veins (p = 0.022). However, the diagnostic value of the flow pattern in the interlobar renal veins for detecting intra-abdominal hypertension was low (ROC curve analysis, area under the curve 0.59).
This study showed absence of association between VExUS score and intra-abdominal pressure in a general ICU cohort. The flow pattern in the interlobar renal veins, although independently associated with intra-abdominal pressure, has low diagnostic value, therefore it cannot be introduced in clinical practice. Further research is required in order to draw safer conclusions.
Main subject category:
Health Sciences
Keywords:
Intra-abdominal hypertension, Venous congestion, VExUS score, Interlobar renal vein flow pattern
