Comparative Study between Femoral Arterial Doppler and Echocardiography in fluid responsiveness assessment in Septic Shock Patients

EL Zahaby, Hany Mohamed Mohamed; El Henawy, Ahmed Mohamed El Sayed; Youssef, Ahmed Monier Ahmed; Ghallab, Eslam Kandil Abd El Moaty

doi:10.21608/ejhm.2018.10746

Comparative Study between Femoral Arterial Doppler and Echocardiography in fluid responsiveness assessment in Septic Shock Patients

Document Type : Original Article

Authors

Department of Anesthesiology, ICU and Pain Management- Ain Shams University

10.21608/ejhm.2018.10746

Abstract

Background: Fluid replacement is considered the cornerstone of resuscitation in critically ill patients especially in patients with septic shock. However, only about 50% of critically ill hemodynamically unstable patients are responsive to fluids. Furthermore, both under resuscitation and overzealous fluid administration adversely affect the outcome. Consequently, the resuscitation of critically ill patients requires an accurate assessment of the patients’ intravascular volume status and their volume responsiveness.
Aim of the Study: The aim of this study is to compare between the femoral arterial doppler and Echocardiography in fluid responsiveness assessment in septic shock patients.
Methodology: The study was conducted on 30 adult male and female patients admitted to Critical Care Department in Ain shams University Hospitals with the diagnosis septic shock. All patients in this study have the Criteria of Septic shock. Echocardiographic examination and femoral Doppler were done for all included patients. Velocity time integral on left ventricle outflow tract and Velocity time integral on femoral artery were measured before and after fluid resuscitation, after infusion of 30 ml/kg over 3 hours,
Results: These results show that there were 23 patients were responded clinically to fluid resuscitation from all total number of 30 patients. From all total number of patients whom clinically responded, 22 patients responded to fluid resuscitation by transthoracic echocardiography and 23 patients responded by femoral Doppler.
Conclusion: These results showed that femoral Doppler parameters were a reliable predictor to fluid responsiveness in patients with severe sepsis and septic shock as well as transthoracic echocardiography in dynamic monitoring of the change in stroke volume after a maneuver that increases or decreases venous return (preload). However femoral Doppler seems to be easier and rapid tools to be used by junior staff.

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