Effects Of Respiratory Variation Index Of The Inferior Vena Cava Internal Diameter On Acute Kidney Injury Caused By Septic Shock

Objective: To explore the effects of respiratory variation index of the inferior vena cava internal diameter(Δ IVC) on acute renal injury(AKI) caused by septic shock in emergency intensive care unit(EICU).Methods: A retrospective study of 62 patients who were diagnosed with septic shock in EICU of The First Teaching Hospital of Xinjiang Medical University from October 1st 2013 to February 31 st 2015 and the Δ IVC were respectively monitored by bedside ultrasound at the beginning and 24 hour after fluid resuscitation was performed. The cases were assigned into low Δ IVC group(Δ IVC<20%,n=32), or high Δ IVC group(Δ IVC≥ 20%,n=30) according to the Δ IVC of 24 hour after fluid resuscitation. The hemodynamic data,APACHE Ⅱ score,serum creatinine, lactate concentration were performed respectively at the beginning and 24 hour after fluid resuscitation. The incidence and mortality of AKI, the outcome of these patients in EICU and at Day 28 post-diagnosis were recorded.Results: There were 25 cases(78.1%) in low Δ IVC group attacked with AKI,while 16 cases(53.3%) in high Δ IVC group were attacked with AKI, the incidence of AKI in low Δ IVC group was significantly higher than that in the high Δ IVC group. A total of 23 patients(37.1%) died in EICU, include 16 cases(50.0%) in low Δ IVC group and 7 cases(23.3%) in high Δ IVC group and 18 cases(56.3%) died at Day 28 post-diagnosis in low Δ IVC group while 11 cases(36.7%) in high Δ IVC group. The emergency intensive care unit mortality in low Δ IVC group was significantly higher than that in the high ΔIVC group,but 28-day mortality there was no statistical difference. Conclusion: A low Δ IVC group may increase and mortality of AKI after septic shock, therefore low Δ IVC should be avoided in clinical treatment.