休克患者快速超声评估流程在评估心脏功能和容量反应性的价值

doi:10.3969/j.issn.1006-6233.2025.01.022

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (1218 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To analyze the value of rapid ultrasound in shock (RUSH) on evaluating the cardiac function and volume responsiveness in patients with shock. Methods: One- hundred patients with shock in Department of Emergency and Critical Care Medicine of People’s Hospital of Ningxia Hui Autonomous Region from January 1, 2022 to January 31, 2024, were enrolled. RUSH regimen in identifying the type of shock was evaluated in diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate. The mechanical ventilation time, hospitalization time, in-hospital mortality, cardiac function (left ventricular ejection fraction [LVEF] on admission and shock correction) and volume responsiveness (inferior vena cava [IVC] diameter, inferior vena cava collapsibility index and more B-line rate after 1 hour of resuscitation) of different shock patients were analyzed. Results: The sensitivity, specificity and accuracy rate of RUSH regimen in 32 cases of cardiogenic shock were 91.67%, 98.68% and 97.00%, respectively; which in 33 cases of hypovolemic shock were 91.67%, 94.74% and 94.00%, respectively; which in 15 cases of obstructive shock were 95.00%, 97.50% and 97.00%, respectively; and which in 20 cases of distributive shock were 90.63%, 98.53% and 96.00%, respectively. There were statistically significant differences in mechanical ventilation time and hospitalization time among patients with different types of shock (P<0.05), but no significant difference was shown in in-hospital mortality (P>0.05). There were statistically significant differences in LVEF on admission and shock correction among patients with different types of shock (P<0.05). The IVC diameter on admission was statistically significant different among patients with different types of shock (P<0.05), but there were no statistically significant differences in IVC collapsibility index and more B-line rate after 1 hour of resuscitation (P>0.05). Conclusion: RUSH regimen has good application value on evaluating cardiac function and volume responsiveness in patients with shock.

Key words： Shock Rapid ultrasound in shock Cardiac function Volume responsiveness

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.01.022 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I1/122

[1] 程超,杨妮,裴亮,等.床旁重症超声对休克患儿的诊治价值研究[J].中国小儿急救医学,2021,28(1):40-44.
[2] 张雪艳,李志峰,王海波,等.改良重症超声快速管理方案在休克患者病因诊断中的作用[J].中华急诊医学杂志,2022,31(7):952-956.
[3] Yanagawa Y,Ohsaka H,Nagasawa H,et al.An analysis using modified rapid ultrasound for shock and hypotension for patients with endogenous cardiac arrest[J].Emerg Trauma Shock,2019,12(2):135-140.
[4] 中华医学会心血管病学分会心血管急重症学组,中华心血管病杂志编辑委员会.心原性休克诊断和治疗中国专家共识(2018)[J].中华心血管病杂志,2019,47(4):265-277.
[5] Kalkwarf KJ,Cotton BA.Resuscitation for hypovolemic shock[J].Surg Clin North Am,2017,97(6):1307-1321.
[6] Ohbe H,Jo T,Yamana H,et al.Early enteral nutrition for cardiogenic or obstructive shock requiring venoarterial extracorporeal membrane oxygenation:a nationwide inpatient database study[J].Intensive Care Med,2018,44(8):1258-1265.
[7] Moranville MP,Mieure KD,Santayana EM.Evaluation and management of shock states:hypovolemic,distributive,and cardiogenic shock[J].Pharm Pract,2011,24(1):44-60.
[8] VanDyck TJ,Pinsky MR.Hemodynamic monitoring in cardiogenic shock[J].Curr Opin Crit Care,2021,27(4):454-459.
[9] Kashani K,Omer T,Shaw AD.The Intensivist's perspective of shock,volume management,and hemodynamic monitoring[J].Clin Am Soc Nephrol,2022,17(5):706-716.
[10] Bocklein M,Beck M,Shmygalev S.Distributiver schock[distributive shock[J].Anaesthesiologie,2023,72(8):608-618.
[11] Khorsand S,Helou MF,Satyapriya V,et al.Not all shock states ae created equal:a review of the diagnosis and management of septic,hypovolemic,cardiogenic,obstructive,and distributive shock[J].Anesthesiol Clin,2023,41(1):1-25.
[12] Yoshida T,Yoshida T,Noma H,et al.Diagnostic accuracy of point-of-care ultrasound for shock:a systematic review and meta-analysis[J].Crit Care,2023,27(1):200.
[13] Bagheri-Hariri S,Yekesadat M,Farahmand S,et al.The impact of using RUSH protocol for diagnosing the type of unknown shock in the emergency department[J].Emerg Radiol,2015,22(5):517-520.