skip to main content

Diameter dan Indeks Inferior Vena Cava (IVC) Berkorelasi dengan Central Venous Pressure (CVP) pada Pasien Kritis yang Menggunakan Ventilasi Mekanik di Intensive Care Unit (ICU)

Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Brawijaya/RSUD Dr. Saiful Anwar, Malang, Indonesia

Received: 30 Oct 2020; Published: 1 Jul 2021.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

Citation Format:
Abstract

Latar belakang: Pengukuran central venous pressure (CVP) merupakan salah satu metode guiding deresusitasi pada pasien dengan kasus tertentu. Kenaikan nilai CVP 1 mmHg dikaitkan dengan peningkatan angka kejadian acute kidney injury (AKI). Namun sebagai sebuah metode yang invasif, pemasangan CVP memiliki risiko yang perlu diperhatikan. Di sisilain, pengukuran diameter dan indeks IVC yang bermuara di atrium kanan dengan menggunakan ultrasonografi (USG) non-invasif dinilai mampu untuk memprediksi nilai CVP pada pasien. Namun beberapa penelitian hubungan antara CVP dengan diameter dan indeks IVC memberikan hasil yang kontroversial.

Tujuan: Penelitian untuk mengetahui hubungan antara nilai CVP dengan diameter dan indeks IVC.

Metode: Penelitian ini menggunakan metode cross-sectional pada 30 pasien yang dilakukan ventilasi mekanik dan pemasangan CVC di unit perawatan intensif. Parameter CVP, diameter minimum dan maksimum inferior vein cava (IVC mak, IVC min), distensibillity index (DI-index), dan aortacaval index (Cava/Ao index) diukur. Data dianalisis menggunakan uji korelasi pada SPPS 18.0 (p<0.05).

Hasil: Didapatkan korelasi signifikan antara CVP dan semua variabel yang diuji (IVC mak, IVC min, DI-index, dan Cava/Ao index) (p<0.05), dengan korelasi terkuat antara CVP dan IVC min (R= 0,908). Korelasi bersifat positif, kecuali antara DI-index dan CVP.

Kesimpulan: Parameter IVC min, IVC mak, Cava/Ao- index, dan DI-index signifikan berkorelasi kuat dengan CVP. Korelasi terjadi bersifat positif, kecuali antara DI-index dan CVP.

Note: This article has supplementary file(s).

Fulltext View|Download |  Research Instrument
Keterangan etik
Subject
Type Research Instrument
  View (49KB)    Indexing metadata
 Research Instrument
Copyright transfer agreement
Subject
Type Research Instrument
  Download (383KB)    Indexing metadata
 Research Instrument
Publication fee
Subject
Type Research Instrument
  View (22KB)    Indexing metadata
Keywords: cava/aorta index; central venous pressure; distensibility index; inferior vena cava; ultrasound

Article Metrics:

  1. Mackenzie DC, Noble VE. Assessing volume status and fluid responsiveness in the emergency department. Clin Exp Emerg Med. 2014;1(2):67-77. doi: 10.15441/ceem.14.040
  2. Boyd JH, Forbes J, Nakada TA, Walley KR, Russell JA. Fluid resuscitation in septic shock: A positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med. 2011;39(2):259-265. doi: 10.1097/CCM.0b013e3181feeb15
  3. Ghafoori Yazdi M, Shoghli A, Faghihi S, Baratloo A. Central Venous Pressure Monitoring; Introduction of a New Device. Emerg (Tehran, Iran). 2016;4(2):52-54. doi: 10.22037/emergency.v4i2.9131
  4. Kalantari K, Chang JN, Ronco C, Rosner MH. Assessment of intravascular volume status and volume responsiveness in critically ill patients. Kidney Int. 2013;83(6):1017-1028. doi: 10.1038/ki.2012.424
  5. Angappan S, Parida S, Vasudevan A, Badhe AS. The comparison of stroke volume variation with central venous pressure in predicting fluid responsiveness in septic patients with acute circulatory failure. Indian J Crit care Med. 2015;19(7):394–400. doi: 10.4103/0972-5229.160278
  6. Chen CY, Zhou Y, Wang P, Qi EY, Gu WJ. Elevated central venous pressure is associated with increased mortality and acute kidney injury in critically ill patients: A meta-analysis. Crit Care. 2020;24(1):1-8. doi: 10.1186/s13054-020-2770-5
  7. Honoré PM, Pierrakos C, Spapen HD. Relationship Between Central Venous Pressure and Acute Kidney Injury in Critically Ill Patients. Published online 2019:303-311. doi: 10.1007/978-3-030-06067-1_23
  8. Yang Y, Ma J, Zhao L. High central venous pressure is associated with acute kidney injury and mortality in patients underwent cardiopulmonary bypass surgery. J Crit Care. 2018;48:211-215. doi: 10.1016/j.jcrc.2018.08.034
  9. Cowie BS, Kluger R, Rex S, Missant C. The relationship between superior vena cava diameter and collapsibility and central venous pressure. Anaesth Intensive Care. 2015;43(3):357-360. doi: 10.1177/0310057x1504300312
  10. Shah P, Louis M. Physiology, Central Venous Pressure. StatPearls [Internet]. StatPearls Publishing; 2021. https://www.ncbi.nlm.nih.gov/books/NBK519493/
  11. Killu K, Coba V, Blyden D, et al. Sonographic Assessment of Intravascular Fluid Estimate (SAFE) Score by Using Bedside Ultrasound in the Intensive Care Unit. Crit Care Res Pract. 2020;2020(Ivc). doi: 10.1155/2020/9719751
  12. Lyon M, Blaivas M, Brannam L. Sonographic measurement of the inferior vena cava as a marker of blood loss. Am J Emerg Med. 2005;23(1):45-50. doi: 10.1016/j.ajem.2004.01.004
  13. Petik B. Inferior vena cava anomalies and variations: imaging and rare clinical findings. Insights Imaging. 2015;6(6):631-639. doi: 10.1007/s13244-015-0431-z
  14. Jia Z, Wu A, Tam M, Spain J, McKinney JM, Wang W. Caval Penetration by Inferior Vena Cava Filters: A Systematic Literature Review of Clinical Significance and Management. Circulation. 2015;132(10):944-952. doi: 10.1161/CIRCULATIONAHA.115.016468
  15. Barbier C, Loubières Y, Schmit C, et al. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30(9):1740-1746. doi: 10.1007/s00134-004-2259-8
  16. Salama ER, Elkashlan M. Pre-operative ultrasonographic evaluation of inferior vena cava collapsibility index and caval aorta index as new predictors for hypotension after induction of spinal anaesthesia: A prospective observational study. Eur J Anaesthesiol. 2019;36(4):297-302. doi: 10.1097/EJA.0000000000000956
  17. Lydia M, Kenneth S. Critical Care Ultrasound. In: Critical Care Secret Textbook. Elsevier; 2018
  18. Ilyas A, Ishtiaq W, Assad S, et al. Correlation of IVC Diameter and Collapsibility Index With Central Venous Pressure in the Assessment of Intravascular Volume in Critically Ill Patients. Cureus. 2017;i(2):0-7. doi: 10.7759/cureus.1025
  19. Govender J, Postma I, Wood D, Sibanda W. Is there an association between central venous pressure measurement and ultrasound assessment of the inferior vena cava? African J Emerg Med. 2018;8(3):106-109. doi: 10.1016/j.afjem.2018.03.004
  20. Boldt J, Lenz M, Kumle B, Papsdorf M. Volume replacement strategies on intensive care units: Results from a postal survey. Intensive Care Med. 1998;24(2):147-151. doi: 10.1007/s001340050536
  21. Yin W, Li Y, Zeng X, et al. The utilization of critical care ultrasound to assess hemodynamics and lung pathology on ICU admission and the potential for predicting outcome. PLoS One. 2017;12(8):1-14. doi: 10.1371/journal.pone.0182881
  22. Sartika LD, Pradian E, Dian N, Sudjud RW, Aditya R. Hubungan Volume Cairan dengan Cardiac Output dan Venous Return pada Pasien Kritis. JAI (Jurnal Anestesiol Indones. 2019;11(3):164-177. doi: 10.14710/jai.v11i3.25251
  23. Chamber D, Huang C, Matthews G. Basic Physiology for Anaesthetists. Second Edi. Cambridge University Pers; 2019
  24. Lesmana H. AKURASI PENGUKURAN TEKANAN VENA SENTRAL (Central Venous Pressure). J Borneo Holist Heal. 2018;1(1):1-13
  25. Stone MB, Huang J V. Inferior vena cava assessment: Correlation with cvp and plethora in tamponade. Glob Heart. 2013;8(4):323-327. doi: 10.1016/j.gheart.2013.11.004

Last update:

No citation recorded.

Last update: 2024-12-23 18:49:56

No citation recorded.