Nghiệm pháp mới đánh giá thể tích dịch ở người suy tim cấp hoặc mạn

Test which confirms acute on chronic systolic heart failure Thach Nguyen, Advait Soni, Ryan Phan, Tri Pham*, Tung Mai, Gianluca Rigatelli Contents • Background • Objectives • Methods – SEFV test – The study • Results • Conclusion Background - The current way to diagnose an acute decompensation on chronic heart failure bases on the state of fluid in the body - Traditional methods to diagnose acute decompensation are complicated Objectives Acute symptomatic heartfailure (with shortness of breath) happends when the capacitance of the intravascular compartment is overwhelmed => New test assesses intravenous fluid Methods - Fluid overload examination: in the extravascular system and in the venous system - The study group underwent the SEFV (Size and Expansibility of the Femoral Vein) test SEFV test The first principle: the volume of blood going through the femoral artery and returning through the common femoral vein should be the same SEFV test The second principle: The veins have high compliance => can contain more blood while the arteries have high vascular tone => keep constant pressure SEFV test Size of the femoral vein can change from the same size to the femoral artery or to be bigger Estimate the amount of blood in the arteries and veins through ultrasound examination SEFV is the ultrasound study examining the size of the femoral vein and its expansion with cough 10 Normal person at rest The size of the femoral vein is a little larger than the size of the common femoral artery 11 Normal person when cough The expansion of the femoral vein to less than times larger than the baseline 12 Abnormal person when cough Abnormal = dehydration or hypovolemia There is no minimal expansion of the femoral vein 13 Fluid overload in the veinous system 14 The study Group A Patients diagnosed based on traditional method Group B Patients diagnosed with the new SEFV results All patients also had beta natriuretic peptide (BNP) level measured 15 Enroll Divide into groups SEFV/traditional method Collect data 16 Results 50 patients with severe SOB were diagnosed with dilated cardiomyopathy with low ejection fraction (mean EF = 36%) 17 Results Diseases Percentage COPD 30% Chronic Kidney Disease 34% Liver Cirrhosis 4% 18 Results HF diagnosis Percentage BNP test 50% SEFV test 95% Clinical diagnosis 70% 19 Conclusions - The SEFV test was more accurate in confirming the diagnosis of acute decompensated heart failure than traditional diagnosis - The diagnosis was based on the significant fluid overload in the venous system as evidenced by the SEFV test 20 Thank you for your attention! 21 ... Size of the femoral vein can change from the same size to the femoral artery or to be bigger Estimate the amount of blood in the arteries and veins through ultrasound examination SEFV is the... common femoral artery 11 Normal person when cough The expansion of the femoral vein to less than times larger than the baseline 12 Abnormal person when cough Abnormal = dehydration or hypovolemia