Predicting and Measuring Fluid Responsiveness by Hemodynamic Indices versus Transthoracic Echocardiography in Clinically Shocked Patients

Abstract

Abstract Background In the last decades dynamic measures had evolved as a better solution to predict fluid responsiveness in clinically shocked patients, out of multiple dynamic parameters we chose transthoracic echocardiographic based measurements of variations of aortic blood flow and inferior vena caval diameter. Aim of the Work to assess accuracy of transthoracic echo measured variation in aortic blood flow and inferior vena caval diameter with limited bolus crystalloid infusion in predicting fluid responsiveness in patients with clinical shock. Patients and Methods This study included 51 selected Patients with acute circulatory failure secondary to clinical shock admitted to ICU. All patients had undergone basic transthoracic echocardiographic (TTE) assessment of aortic blood flow (using left ventricular outflow tract velocity time integral as a surrogate) and inferior vena caval diameter changes with respiratory cycle, these measures were obtained at time of diagnosis of shock and repeated after infusion of 300 ml crystalloid fluid bolus (over fifteen minutes). Results Our results had revealed significant difference between responders and non-responders regarding aortic flow variation after fifteen minutes. Conclusion Based on the results obtained in this study, it was proved that transthoracic echocardiography can be used as an accurate method to predict fluid responsiveness in shocked patient with fluid challenge.