Abstract:

Objective To understand the blood volume status and volume reactivity of patients with sepsis using bedside ultrasound under mechanical ventilation. Methods 136 cases of sepsis patients with breathing machine treatment were chosen at random from May 2017 to Sep 2020 in ICU 2 of the first Affiliated Hospital of Guangxi Medical University，and ICU 2 and 1 of Guangxi integrated traditional Chinese and western medicine hospital affiliated to Guangxi university of traditional Chinese medicine. The indicators of bedside ultrasound were recorded as the indicators of PICCO were obtained synchronously in ICUs，respectively. The indicators were end⁃ diastolic volume index，the variation rate of stroke，the minimum diameter of the inferior vena cava（IVC），inferior vena cava expansion index and NT ⁃ proBNP. Analysis were performed according to the data properties. Result Groups of End ⁃diastolic volume index of IVCDmin difference was statistically significant（P < 0.05），and value of End⁃diastolic volume index group in IVCDmin were（1.57 ± 0.32）cm. The optimal cut⁃off point for the smallest IVCDmin reflecting body volume deficiency was 1.35 cm，the sensitivity and specificity were 86.40% and 84.80%， respectively（P < 0.01），and the optimal cutoff point of the minimum IVCDmin reflecting the body volume overload was 1.81 cm，the sensitivity and specificity were 76.50% and 89.60%，respectively（P < 0.01）. The gold standard of cutoff point for effective volume reactivity of inferior vena cava expansion index was 14.47% ，sensitivity and specificity were 87.7%，81.0%（P < 0.01）. Conclusion In patients with sepsis under mechanical ventilation， when the IVCDmin was less than 1.35 cm，it should be paid to the state of insufficient blood volume. If the IVCDmin is greater than 1.81 cm，body volume overload should be early warned. And It should be evaluated timely of the body ± s blood volume status and volume reactivity in order to accurately guide the fluid management.

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