Objective: This paper measures whether there is any difference between the non-invasive monitoring technology that shows the change in ICP value and the current "gold standard" intraventricular probe-type intracranial pressure monitoring technology. Methods: 61 critically ill patients with traumatic brain injury requiring invasive ICP monitoring in the intensive care unit of our hospital from April 2017 to September 2017 were selected. The study subjects were selected in strict accordance with the inclusion and exclusion criteria of experimental design. Each patient recorded the ICP values before and after intravenous drip of 20% mannitol 125 ml, and received ultrasound measurements at bedside by two different physicians before, after, 10 minutes, and 30 minutes after ICP changes. Results: The consistency of the ONSD values measured by different doctors at the same time was the same, and the repeatability of the bedside ultrasound measurement of the ONSD values was better. There was no significant difference between the ONSD value measured immediately after the ICP drop and the ONSD value before the ICP drop. There was a significant difference between the ONSD value measured 10 minutes after the ICP drop and the ONSD value before the ICP drop. However, there was no significant difference in the value of ONSD measured between 10 minutes and 30 minutes after the ICP decreased. Conclusion: ONSD reflects that the lag time window of ICP changes is within 10 minutes, but the measured values of ONSD within the 20-minute period from 10 minutes to 30 minutes after ICP changes can better reflect the current ICP values.
Background/Aim. Septic shock is a serious complication that can occur as consequence of infection. As the effective circulating blood volume is of vital importance in these cases, it is very important to keep track of this parameter constantly. The aim of this study was to explore the application value of bedside ultrasound for assessing volume responsiveness in patients with septic shock. Methods. A total of 102 patients with septic shock were selected. The volume load (VL) test was performed, and based on the results of the test, the patients were divided into the response group that had an increase in stroke volume (?SV ) ? 15% and non-response group (?SV < 15%). Hemodynamic parameters were compared before and after the test. The correlation between ?SV and each hemodynamic index was explored by Pearson?s analysis. The receiver operating characteristic (ROC) curve was plotted. Results. There were 54 patients in response group and 48 patients in non-response group. Before VL test, retro-hepatic inferior vena cava (IVC) distensibility index (?IVC1), respiratory variation in IVC index (?IVC2), respiratory variation in aortic blood flow peak velocity index (?VpeakAO), respiratory variation in brachial artery blood flow peak velocity index (?VpeakBA) and respiratory variation in common femoral artery blood flow peak velocity index (?VpeakCFA) were all higher in response group than those in non-response group (p < 0.05), while heart rate (HR), mean arterial pressure (MAP) and central venous pressure (CVP) were similar (p > 0.05). After VL test, response group had significantly decreased HR, ?IVC1, ?IVC2, ?VpeakAO, ?VpeakBA and ?VpeakCFA, and increased MAP and CVP (p < 0.05), while non-response group had significantly decreased CVP (p < 0.05) and no significant changes in other indices. ?IVC1, ?IVC2, ?VpeakAO, ?VpeakBA and ?VpeakCFA significantly correlated with ?SV ( r= 0.589, r = 0.647, r = 0.697, r = 0.621, r = 0.766, p < 0.05), but there was no correlation between CVP and ?SV (r = -0.345, p > 0.05). The areas under the curves of ?IVC1, ?IVC2, ?VpeakAO, ?VpeakBA and ?VpeakCFA for predicting volume responsiveness were 0.839, 0.858, 0.878, 0.916 and 0.921, respectively, which were significantly larger than that of CVP (0.691), indicating higher sensitivity and specificity. Conclusion. Bedside ultrasound monitoring of ?IVC, ?VpeakAO, ?VpeakBA and ?VpeakCFA can better assess the volume responsiveness in patients with septic shock.
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