The PCQP score for volume status of acutely ill patients: Integrating vascular pedicle width, caval index, respiratory variability of the qrs complex and R wave amplitude

Abstract

Introduction:Techniques for measuring volume status of critically ill patients include invasive, less invasive, or noninvasive ones. The present study aims to assess the accuracy of noninvasive techniques for measuring volume status of critically ill patients.Patients and Methods:A total of 111 critically ill patients admitted to the emergency department and undergoing central venous catheterization were included in the study. Five parameters were measured including vascular pedicle width (VPW), diameter of inferior vena cava, caval index, respiratory changes in QRS, and P wave amplitude. Patients with risk factors which could decrease the accuracy of central venous pressure (CVP) value were excluded from study. We compared these parameters with static CVP parameter. Finally, based on the afore-mentioned parameters, PCQP role in criteria was designed.Results:In detecting loss of circulating blood volume, area under the curve of VPW was 0.92 (90%, confidence interval [CI]: 0.85–0.99), diameter of inferior vena cava was 0.82 (90%, CI: 0.72–0.91), caval index was 0.9 (90%, CI: 0.82–0.98), and changes in QRS and P waves were 0.88 (95%, CI: 0.81–0.95) and 0.73 (95%, CI: 0.63–0.82), respectively. PCQP role in criteria was designed according to these parameters, and at its best cutoff point (score 6), VPW had a sensitivity of 97.4% (95%, CI: 84.57–99.99) and specificity of 83.6% (95%, CI: 72.65–90.86) for the detection of loss of circulating blood volume (<8 cmH2O).Conclusion:PCQP score could be a reliable and noninvasive technique for the assessment of volume status in critically ill patients.

Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study

“…9 There are many studies about the predictive value of IVC diameter variation in critically ill patients regarding fluid responsiveness with controversial results. [10][11][12][13][14] Based on the mentioned studies, we wanted to compare the cardiac output values, IVC diameters and lactate levels as predictors of mortality in critically ill non-traumatic patients in ED.…”

Uji Kesesuaian Hasil Penilaian Status Volume Intravaskular Antara Diameter Vena Cava Inferior (IVC) dengan Vascular Pedicle Width (VPW)

“…Pemeriksaan radiografi dada di Intensive Care Unit (ICU) harus dapat diulang sebab posisi tubuh yang sama dan jarak film dengan dinding dada standar yang standar sangat diperlukan. 17 Studi ini bertujuan untuk untuk mengetahui kesesuaian antara pengukuran diameter IVC dengan USG dan pengukuran VPW dengan radiografi.…”