Jacquemijns, Merel (2020) Portal vein pulsatility in the critically ill; feasible but not yet applicable as a proxy for congestion. thesis, Medicine.
Full text available on request.Abstract
Background: Congestion is associated with worse outcomes in the critically ill. Current measuring tools for congestion are limited and unreliable. This prospective cohort study aimed to investigate the feasibility of measuring the portal vein (PV) pulsatility in the critically ill and aimed to determine whether PV pulsatility can serve as a proxy for congestion. Differences were studied between the group with and without PV pulsatility. In addition, associations with short term mortality were studied. Methods: All acutely admitted patients of the adult intensive care unit (ICU) in a large tertiary hospital of the Netherlands underwent ultrasound. Portal vein flow pattern and inferior vena cava (IVC) collapsibility were measured within 24 hours of ICU admission. Furthermore, baseline characteristics, fluid balance and vital signs were documented. Results: A total of 90 patients were included. Portal vein flow pattern measurements were feasible in 78 patients (87%). Portal vein pulsatility, defined as pulsatility fraction >50%, was present in 30 patients (38%). No significant differences were found in baseline characteristics, fluid balance and IVC collapsibility index between the group with and without PV pulsatility. No significant association was present between PV pulsatility and short-term mortality. Conclusion: Portal vein pulsatility is a feasible but not yet applicable tool to detect congestion in the critically ill. This might be explained by the heterogeneity within the ICU population or influencing factors, such as comorbidities, patient position, and cardiac diseases. Further research is necessary to assess the use of PV pulsatility as a proxy for congestion.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Koeze, J. and de Haas, R.J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Nov 2023 12:32 |
| Last Modified: | 06 Nov 2023 12:32 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3722 |
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