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

OBJECTIVE: Fluid overload is an independent marker for mortality in critically ill patients. Assessment of fluid status and fluid responsiveness is crucial for the management of these patients. In this study, we compared the lactate level, inferior vena cava (IVC) diameter and non-invasive cardiac o...

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Autores principales: Shahsavarinia, Kavous, Taqizadieh, Ali, Moharramzadeh, Payman, Amirchoupani, Ramin, Mahmoodpoor, Ata
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Professional Medical Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260899/
https://www.ncbi.nlm.nih.gov/pubmed/32494275
http://dx.doi.org/10.12669/pjms.36.4.2032
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author Shahsavarinia, Kavous
Taqizadieh, Ali
Moharramzadeh, Payman
Amirchoupani, Ramin
Mahmoodpoor, Ata
author_facet Shahsavarinia, Kavous
Taqizadieh, Ali
Moharramzadeh, Payman
Amirchoupani, Ramin
Mahmoodpoor, Ata
author_sort Shahsavarinia, Kavous
collection PubMed
description OBJECTIVE: Fluid overload is an independent marker for mortality in critically ill patients. Assessment of fluid status and fluid responsiveness is crucial for the management of these patients. In this study, we compared the lactate level, inferior vena cava (IVC) diameter and non-invasive cardiac output (CO) monitoring in prediction of mortality in emergency department. METHODS: This was a cross sectional observational study which comprised of 68 patients and was performed in ED of Tabriz University of Medical Sciences, Iran, from Sept 2016 until Sept 2017. IVC diameter was measured before the P-wave on ECG to avoid interference with a-wave and v-wave on the venous pressure curve, and during maximal inspiration and expiration to avoid Valsalva-like maneuvers. An arterial lactate sample was taken from all patients before performing the initial resuscitation. All patients underwent non-invasive CO monitoring by CO(2) rebreathing technique. Mortality was noted on day 28. RESULTS: Deceased patients had a significantly low level of IVC diameters, less CO values and more lactate levels. However, based on ROC curve analysis, the prediction accuracy and validity of both CO values obtained by rebreathing CO(2) and IVC diameter was poor and the highest accuracy was obtained by lactate level assessment. CONCLUSION: Initial lactate value is a reliable parameter for prediction of mortality in non-traumatic critically ill patients. IVC diameter changes during spontaneous ventilation and non-invasive CO monitoring does not possess acceptable accuracy for prediction of mortality in these patients.
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spelling pubmed-72608992020-06-02 Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study Shahsavarinia, Kavous Taqizadieh, Ali Moharramzadeh, Payman Amirchoupani, Ramin Mahmoodpoor, Ata Pak J Med Sci Original Article OBJECTIVE: Fluid overload is an independent marker for mortality in critically ill patients. Assessment of fluid status and fluid responsiveness is crucial for the management of these patients. In this study, we compared the lactate level, inferior vena cava (IVC) diameter and non-invasive cardiac output (CO) monitoring in prediction of mortality in emergency department. METHODS: This was a cross sectional observational study which comprised of 68 patients and was performed in ED of Tabriz University of Medical Sciences, Iran, from Sept 2016 until Sept 2017. IVC diameter was measured before the P-wave on ECG to avoid interference with a-wave and v-wave on the venous pressure curve, and during maximal inspiration and expiration to avoid Valsalva-like maneuvers. An arterial lactate sample was taken from all patients before performing the initial resuscitation. All patients underwent non-invasive CO monitoring by CO(2) rebreathing technique. Mortality was noted on day 28. RESULTS: Deceased patients had a significantly low level of IVC diameters, less CO values and more lactate levels. However, based on ROC curve analysis, the prediction accuracy and validity of both CO values obtained by rebreathing CO(2) and IVC diameter was poor and the highest accuracy was obtained by lactate level assessment. CONCLUSION: Initial lactate value is a reliable parameter for prediction of mortality in non-traumatic critically ill patients. IVC diameter changes during spontaneous ventilation and non-invasive CO monitoring does not possess acceptable accuracy for prediction of mortality in these patients. Professional Medical Publications 2020 /pmc/articles/PMC7260899/ /pubmed/32494275 http://dx.doi.org/10.12669/pjms.36.4.2032 Text en Copyright: © Pakistan Journal of Medical Sciences http://creativecommons.org/licenses/by/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Shahsavarinia, Kavous
Taqizadieh, Ali
Moharramzadeh, Payman
Amirchoupani, Ramin
Mahmoodpoor, Ata
Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study
title Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study
title_full Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study
title_fullStr Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study
title_full_unstemmed Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study
title_short Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study
title_sort comparison of cardiac output, ivc diameters and lactate levels in prediction of mortality in patients in emergency department; an observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260899/
https://www.ncbi.nlm.nih.gov/pubmed/32494275
http://dx.doi.org/10.12669/pjms.36.4.2032
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