Evaluation value of bedside ultrasound monitoring of peak flow velocity of abdominal aorta and its branches in volume status of patients with septic shock

Abstract

[Abstract] Objective To explore the value of bedside ultrasound in monitoring peak flow velocity of abdominal aorta and its branches in assessing the volume status of patients with septic shock.Methods A total of 80 patients with septic shock admitted to the Foshan Rehabilitation Hospital(The Fifth People's Hospital of Foshan) and the Guangdong Provincial People's Hospital from June 2022 to June 2023 were selected as the research subjects. All patients were treated with mechanical ventilation,and deep venous catheters were placed in the internal jugular vein or subclavian vein to monitor central venous pressure (CVP).PiCCO catheters were placed in the femoral artery to monitor hemodynamic data.At the same time,the maximum internal diameter of the inferior vena cava (IVCmax),the respiratory variation of the inferior vena cava (△IVC),the peak flow velocity of the abdominal aorta (VpeakAA),the peak flow velocity of the celiac artery (VpeakCA),and the peak flow velocity of the superior mesenteric artery (VpeakSMA)were monitored under bedside ultrasound.The global end-diastolic volumn index(GEDI)was used as a grouping indicator,with GEDI≤680ml/m2 as the low-volume group and GEDI≥800ml/m2 as the high-volume group.Compare the differences in peak flow velocity between the abdominal aorta,celiac artery,and superior mesenteric artery between the two groups,and analyze the correlation between peak flow velocity of the abdominal aorta,celiac artery,and superior mesenteric artery and IVCmax,ΔIVC,CVP,and stroke volume variability (SVV);draw a receiver operating characteristic (ROC) curve for the subjects,calculate the area under the curve,and find the diagnostic threshold.Results There was no significant difference in general data between the two groups (P>0.05).The VpeakAA,VpeakCA,and VpeakSMA in the high-volume group were all higher than those in the low-volume group, and the differences were statistically significant (P<0.05). However,VpeakCA and VpeakSMA were significantly correlated with IVCmax,△IVC,CVP,and SVV (P<0.05).The ROC curve analysis showed that VpeakAA,VpeakCA,and VpeakSMA could effectively evaluate the volume status of patients with septic shock, and the area under the VpeakSMA curve was 0.846,with a 95% confidence interval of 0.693-0.999,and had high sensitivity and specificity.Conclusion Bedside ultrasound can dynamically monitor VpeakAA,VpeakCA,and VpeakSMA,which has great value in the evaluation of volume status in patients with septic shock.