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MP53: A feasibility analysis for successful completion of IVC ultrasound in hypotensive emergency department patients

Published online by Cambridge University Press:  13 May 2020

R. Dunfield
Affiliation:
Dalhousie University, Saint John, NB
P. Ross
Affiliation:
Dalhousie University, Saint John, NB
C. Keyes
Affiliation:
Dalhousie University, Saint John, NB
J. Fraser
Affiliation:
Dalhousie University, Saint John, NB
D. Lewis
Affiliation:
Dalhousie University, Saint John, NB
P. Boreskie
Affiliation:
Dalhousie University, Saint John, NB
C. Pham
Affiliation:
Dalhousie University, Saint John, NB
S. Ali Alrobaian
Affiliation:
Dalhousie University, Saint John, NB
F. Scheuermeyer
Affiliation:
Dalhousie University, Saint John, NB
H. Lamprecht
Affiliation:
Dalhousie University, Saint John, NB
M. Stander
Affiliation:
Dalhousie University, Saint John, NB
R. Henneberry
Affiliation:
Dalhousie University, Saint John, NB
A. Sibley
Affiliation:
Dalhousie University, Saint John, NB
P. Atkinson
Affiliation:
Dalhousie University, Saint John, NB

Abstract

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Introduction: Determining fluid status prior to resuscitation provides a more accurate guide for appropriate fluid administration in the setting of undifferentiated hypotension. Emergency Department (ED) point of care ultrasound (PoCUS) has been proposed as a potential non-invasive, rapid, repeatable investigation to ascertain inferior vena cava (IVC) characteristics. Our goal was to determine the feasibility of using PoCUS to measure IVC size and collapsibility. Methods: This was a planned secondary analysis of data from a prospective multicentre international study investigating PoCUS in ED patients with undifferentiated hypotension. We prospectively collected data on IVC size and collapsibility using a standard data collection form in 6 centres. The primary outcome was the proportion of patients with a clinically useful (determinate) scan defined as a clearly visible intrahepatic IVC, measurable for size and collapse. Descriptive statistics are provided. Results: A total of 138 scans were attempted on 138 patients; 45.7% were women and the median age was 58 years old. Overall, one hundred twenty-nine scans (93.5%; 95% CI 87.9 to 96.7%) were determinate. 131 (94.9%; 89.7 to 97.7%) were determinate for IVC size, and 131 (94.9%; 89.7 to 97.7%) were determinate for collapsibility. Conclusion: In this analysis of 138 ED patients with undifferentiated hypotension, the vast majority of PoCUS scans to investigate IVC characteristics were determinate. Future work should include analysis of the value of IVC size and collapsibility in determining fluid status in this group.

Type
Moderated Poster Presentations
Copyright
Copyright © Canadian Association of Emergency Physicians 2020