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Evaluation of the utility of cardiac ultrasonography of patients in a surgical intensive care unit

Supparerk Prichayudh
Supparerk Prichayudh
, 
Tatsana Uthaithammarat
Tatsana Uthaithammarat
, 
Phornlert Chatrkaw
Phornlert Chatrkaw
, 
Sahadol Poonyathawon
Sahadol Poonyathawon
, 
Thammasak Thawitsri
Thammasak Thawitsri
, 
Kanya Kumwilaisak
Kanya Kumwilaisak
, 
Manasnun Kongwibulwut
Manasnun Kongwibulwut
 and 
Nalin Chokengarmwong
Nalin Chokengarmwong
   | Jan 31, 2017
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Article Category: Brief communication (Original)
Published Online: Jan 31, 2017
Page range: 173 - 179
DOI: https://doi.org/10.5372/1905-7415.1002.479
Keywords
© 2016 Supparerk Prichayudh, Tatsana Uthaithammarat, Phornlert Chatrkaw, Sahadol Poonyathawon, Thammasak Thawitsri, Kanya Kumwilaisak, Manasnun Kongwibulwut, Nalin Chokengarmwong
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

IVC diameter measurement via the subxiphoid view was performed within 2 cm of the IVC-right atrial junction at the end of expiration. The collapsibility index of IVC was also calculated.
IVC diameter measurement via the subxiphoid view was performed within 2 cm of the IVC-right atrial junction at the end of expiration. The collapsibility index of IVC was also calculated.

Figure 2

Fractional shortening was measured via the parasternal long axis view.
Fractional shortening was measured via the parasternal long axis view.

Figure 3

Ultrasonography of a 60 year-old male patient suffering abdominal compartment syndrome after a ventral hernia repair demonstrated a collapsed IVC (white arrow). The patient underwent decompressive laparotmy and survived.
Ultrasonography of a 60 year-old male patient suffering abdominal compartment syndrome after a ventral hernia repair demonstrated a collapsed IVC (white arrow). The patient underwent decompressive laparotmy and survived.

Figure 4

A weakly positive correlation was found between the diameter of the inferior vena cava and the central venous pressure, Pearson’s r = 0.45. The solid line shows the regression and dashed lines show the upper and lower 95% confidence intervals.
A weakly positive correlation was found between the diameter of the inferior vena cava and the central venous pressure, Pearson’s r = 0.45. The solid line shows the regression and dashed lines show the upper and lower 95% confidence intervals.

Outcomes of 157 patients who underwent cardiac ultrasonography in the SICU

Ventilator days (mean ± SD)10.9 ±14.8
Days in intensive care unit (mean ± SD)12.9 ±14.7
Mortality (%)23 (15%)
 Sepsis with multiorgan failure17
 Acute respiratory distress syndrome3
 Acute myocardial infarction1
 End stage heart disease1
 Severe hypoxic brain injury1
Changes in management71
 Fluid challenges38
 Inotropic drug managements7
 Anticoagulant administrations11
 Urinary catheter changes2
 Drainages of pleural effusion8
 Drainages of intraabdominal fluid4
 Cholecystectomy1

Demographic data, monitoring device, and inotropic drug use of 157 patients in the SICU who underwent cardiac ultrasonography

Sex
 Male96 (61%)
 Female61 (39%)
Age (years, mean± SD)63.5± 19.4
Average SOFA scores (mean ± SD)6.1 ±4.4
Patient groups
 General surgery35 (22%)
 Trauma31 (20%)
 Vascular surgery28 (18%)
 Colorectal surgery25 (16%)
 Hepatobiliary-pancreatic surgery24 (15%)
 Urology7 (4%)
 Orthopaedics1 (1%)
 Miscellaneous6 (4%)
Central venous pressure monitoring109 (69%)
Arterial catheter133 (85%)
Cardiac output monitoring12 (8%)
 Noninvasive9 (6%)
 Pulmonary arterial catheter3 (2%)
Inotropic drugs74 (47%)

Indications for cardiac ultrasonography

IndicationsNo. of patients (n = 157)Times cardiac ultrasonography performed (n = 190)
Shock58 (37%)69 (37%)
Oliguria28 (18%)35 (18%)
Assessment of hemodynamic status63 (40%)78 (41%)
Other:8 (5%)8 (4%)
 Exclude pleural effusion3 (2%)3 (2%)
 Exclude intraabdominal collection/ sepsis3 (2%)3 (2%)
 Exclude pulmonary embolism2 (1%)2 (1%)
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Language:
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