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Role of lung ultrasound in assessment of endpoint of fluid therapy in patients with hypovolemic shock

Egyptian Journal of Anaesthesia • 2021
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Publication Information
Authors Ehab S. Abdalazeema , Ahmed G. Elgazzarb , May E. M. A. Hammadc and Rehab E. Elsawy
Keywords Hypovolemic shock; fluid therapy; lung ultrasound; fluid resuscitation
Journal Egyptian Journal of Anaesthesia
Publisher Tylor&Francis
Volume 37
Issue 1
Pages 167-173
publication.type International
Paper Link Not Available
Supplementary Materials Not Available
Abstract
ABSTRACT
Background: Different techniques are employed to assess the endpoint of fluid therapy in
hypovolemic patients. Lung ultrasound (US) is increasingly becoming a diagnostic tool in the
critical care setting, providing standardized data. The present study aimed to evaluate the role
of lung US in comparison to central venous pressure (CVP) in assessment of endpoint of fluid
therapy in patients with hypovolemic shock.
Patients and methods: Observational cross-sectional study carried in 60 adult patients with
hypovolemic shock admitted to the intensive care unit received lactated Ringer’s solution. CVP,
blood pressure (BP), urine output (UOP), and lung US score were recorded on admission and
during the period of resuscitation. Lung US score was correlated with CVP, BP, and UOP and
evaluated in assessment of endpoint fluid therapy in comparison to CVP as a gold standard.
Results: There was a significant increase in CVP, BP, UOP,and lung US score during fluid
resuscitation. Lung US showed a significant positive correlation with CVP, BP, and UOP at
different stages of fluid resuscitation. Lung US score showed a sensitivity of 95.7%, specificity of
92.9% with a positive predictive value of 97.8% negative predictive value of 86.7%, and the
total accuracy was 95%.
Conclusion: Lung US provides a simple noninvasive approach in assessment of endpoint (score
≥16) of fluid therapy in patients with hypovolemic shock with high sensitivity and specificity.