Effectiveness of Bedside Sonography by Residents for Fluid Management by Inferior Vena Cava Assessment.

INTENSIVE care units; BLOOD pressure; FLUID therapy; HOSPITAL medical staff; ACQUISITION of data methodology; POINT-of-care testing; ARTERIES; SHOCK (Pathology); CONTINUING education units; RETROSPECTIVE studies; CASE-control method; APACHE (Disease classification system); MANN Whitney U Test; T-test (Statistics); MEDICAL records; HEART beat; VENA cava inferior; STATISTICAL sampling; DATA analysis software

Objective: To study the utility of point of care ultrasound (POCUS) in the diagnosis and management of shock when performed by medicine residents. Methods: A retrospective, case-control study was carried out in the medical intensive care unit at a tertiary care hospital. Consecutive patients who had received bolus fluid for hypotension during the hospital stay were screened from the case sheets and recorded. Results: A total of 57 patients were recruited into the study. Baseline parameters were comparable in both groups. The median amount of fluid given by the physician was 1000 milliliters (500, 1500) in the inferior vena cava (IVC) group as compared with 1000 milliliters (500, 1000) in the clinical group which was similar between the groups (P =.51). The median quantity of fluid received in the first hour in the IVC group (500 milliliters; 75, 750) was significantly higher than in the clinical group (100 milliliters; 100, 125) (z = 2.98; P =.003). More improvement in heart rate (P =.0004), mean arterial pressure (MAP; P =.04), and Acute Physiology and Chronic Health Evaluation (APACHE; P =.0004) score was seen in the IVC group which was statistically significant. Conclusion: In this cohort, there was a significant increase in MAP, reduction in the APACHE II score, and heart rate in the IVC group when compared with the clinical group. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Diagnostic Medical Sonography is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)