床旁超声预测ICU脓毒症休克患者容量反应性的临床价值OA

Objective To explore the predictive value of bedside ultrasound for the volume responsiveness of patients with septic shock(SS)in the ICU.Methods The clinical data of 68 patients with SS admitted to the ICU of Changping District Traditional Chinese Medicine Hospital from August 2023 to August 2025 were retrospectively analyzed.The patients were divided into the experimental group(n=36)and the control group(n=32)based on positive volume responsiveness.All patients underwent bedside ultrasound examination.The differences in ultrasound indicators before the volume load test between the two groups and their correlation with increased cardiac index(ΔCI)were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of each ultrasound indicator for the volume responsiveness of SS patients.Results The carotid Doppler peak velocity variation(ΔCDPV),the carotid blood flow variation(ΔCBF),and the delta inferior vena cava diameter(ΔIVCd)before the volume load test in the experimental group were higher than those in the control group,and the differences were statistically significant(P＜0.05).ΔCDPV,ΔIVCd,and ΔCBF of SS patients were positively correlated with ΔCI(P＜0.05).The area under curve(AUC)of ΔCDPV,ΔIVCd,and ΔCBF for predicting the volume responsiveness of SS patients were 0.721,0.687,and 0.845,respectively.Among them,ΔCBF had the highest predictive sensitivity(0.722),specificity(0.937),and Youden index(0.659),all of which were higher than other indicators.Conclusion The ultrasound indicators ΔCDPV,ΔIVCd,and ΔCBF of bedside ultrasound are all effective indicators for predicting the volume responsiveness of SS patients.Among them,ΔCBF has the highest predictive value.