ASSESSMENT OF VOLUME IN PATIENTS WITH SEVERE PNEUMONIA AND SEPTIC SHOCK BY SEVERE ULTRASOUND

Objective: The critical ultrasound was applied to measure the inferior vena cava (IVC) of patients with severe pneumonia and septic shock to explore reasonable control of volume resuscitation of these patients through obtaining appropriate IVC data of patients. Methods: Patients with severe pneumonia and septic shock admitted to our department from March 2017 to February 2018 were enrolled. According to the IVC grouping, the lactic acid and oxygenation index were compared between the groups, and the IVC values of patients with different lactic acid and oxygenation index, the similarities and differences of IVC between the two groups of survival and the dead patients were compared. Results: Regarding IVCmin, the lactic acid of the 1.5 <= IVC< 2cm group was the lowest, whereas the oxygenation index of this group was the highest. Regarding IVCmax, the lactic acid of the 1.5 <= IVC< 2cm group was the lowest, whereas the oxygenation index of the 2 <= IVC< 2.5cm group was the highest. The IVCmin of patients with lactic acid <= 2mmol/L was 1.46 +/- 0.51cm, the IVCmax of whom was 1.92 +/- 0.39cm; the IVCmin of patients with oxygenation index >= 200mmHg was 1.44 +/- 0.51cm, the IVCmax of whom was 1.91 +/- 0.37cm. IVCmin of the Survival patients was 1.47 +/- 0.53 cm, and the IVCmax of them was 1.89 +/- 0.43 cm. Conclusion: In patients with severe pneumonia with shock, the voume regulation should neither be too small nor too big, which can be controlled through the measurement of IVC by critical ultrasound. IVC of the patients should be controlled at: IVCmin 1.47 +/- 0.53 cm, IVCmax 1.89 +/- 0.43 cm.