Ultrasound Evaluation Of Right Ventricular Function Changes Before And After Continuous Renal Replacement Therapy

Objectives Color Doppler ultrasound observation of changes in right ventricular function and volume in patients with chronic renal failure before and after continuous renal replacement therapy,and explore the relationship between right ventricular function and central venous pressure(CVP).Methods Seventy-one patients with chronic renal failure who underwent continuous renal replacement therapy at the North China University of Technology Affiliated Hospital from April 2019 to September 2019.Clinical data and echocardiographic parameters were collected,including Tricuspidannular plane systolicexcursion(TAPSE),Fractional area change(FAC),Peak systolic velocity(S’),Peak tricuspid valve early blood flow velocity(E),Peak tricuspid annulus early diastolic velocity(e’),Peak tricuspid annulus diastolic peak motion velocity(a’),Peak tricuspid valve early blood flow velocity/Peak tricuspid annulus early diastolic velocity(E/e’),Peak tricuspid annulus early diastolic velocity /Peak tricuspid annulus diastolic peak motion velocity(e’/a’),Peak tricuspid regurgitation velocity(TRmax),Pulmonary arterial systolic pressure(PASP),Right ventricular end-diastolic volume(RV EDV),RV transverse diameter [RVDd(base)],Right atrium end-diastolic area(RA EDA),Right atrial transverse diameter(RAT),Right Atrium Length(RAL).The changes of right ventricular function and volume parameters in patients with chronic renal failure before and after continuous renal replacement therapy were compared,and explore the correlation between TAPSE and CVP before continuous renal replacement therapy in patients with chronic renal failure.Using SPSS 22.0 statistical software,the measurement data is represented by (?).Pairwise samples of normal distribution are compared with paired sample t-test;paired samples with non-normal distribution are compared with Wilcoxon sign rank test.The correlation analysis of normal distribution uses Pearson.Correlation analysis method,non-normal distribution correlation analysis using Spearman rank correlation analysis method,P<0.05 is considered statistically significant.Results 1 The heart rate,systolic blood pressure and diastolic blood pressure of CRRT patients were not statistically significant.Compared with before continuous renal replacement therapy(P>0.05).2 Compared with before continuous renal replacement therapy,RA EDA,RAT,RV EDV,and [RVDd(base)] decreased after continuous renal replacement therapy,and the difference was statistically significant(P<0.05),there was no significant difference between RAL before and after continuous renal replacement therapy(P>0.05).3 The TAPSE before continuous renal replacement therapy was(15.37±4.45)mm,the TAPSE after continuous renal replacement therapy increased by(16.89±5.01)mm,the FAC before continuous renal replacement therapy was(46.12±10.57)mm,and the FAC after continuous renal replacement therapy increased by(48.88±11.90)mm,the difference was statistically significant(P<0.05).There was no significant difference between S’ before and after continuous renal replacement therapy(P>0.05).4 There were no significant differences between e’,a’,e’/a’,and E/e’ before and after continuous renal replacement therapy(P>0.05).5 TRmax before continuous renal replacement therapy was(1.92±1.02)m/s,TRmax decreased after continuous renal replacement therapy(1.72±1.02)mm,PASP before continuous renal replacement therapy was(19.16±14.67)mm Hg,continuous kidney After replacement therapy,PASP(15.45±13.45)mm decreased,and the difference was statistically significant(P<0.05).6 Correlation between TAPSE and CVP before continuous renal replacement therapy in patients with chronic renal failure(r=-0.592,P<0.001),CVP increases as TAPSE decreases.Conclusions 1 Continuous renal replacement therapy can reduce right heart volume,change the right heart geometry,and improve right heart volume overload.2 Continuous renal replacement therapy can improve right ventricular local contraction in patients with chronic renal failure.3 Continuous renal replacement therapy can reduce right ventricular pressure and reduce tricuspid regurgitation,thereby further reducing the right ventricular load.4 TAPSE is an indirect indicator of CVP and helps clinicians with capacity management.Figure4;Table5;Reference 134...