![]() Previous studies have shown that some parameters may be related to volume status. However, clinicians often have inaccurate, nonspecific information to guide treatment. Therefore, it is important to obtain reliable information about fluid responsiveness in patients with circulatory failure in the intensive care unit. Inappropriate administration of fluids has deleterious effects, including volume overload, systemic and pulmonary edema, and limitation of oxygen diffusion to tissues, thereby leading to increased tissue hypoxia. The findings of this study suggest that the ΔIVCD performed moderately well in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation.įluid resuscitation remains the cornerstone of treatment for patients with acute circulatory failure. The pooled sensitivity and specificity for the overall population were 0.69 (95% CI, 0.51–0.83) and 0.80 (95% CI, 0.66–0.89), respectively. Heterogeneity between studies was assessed with an overall Q = 0.069, I 2 = 0%, and P = 0.483. The cutoff values of ΔIVCD varied across studies, ranging from 8% to 21%. Overall, 603 patients were included in this review, 324 (53.7%) of whom were fluid-responsive. The summary ROC curve was estimated, and the area under the ROC curve (AUROC) was calculated. The diagnostic OR (DOR), sensitivity, and specificity were calculated. PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched up to June 2017. The aim of this meta-analysis was to explore the value of ΔIVCD for predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation. The improvement in LVEF and LVESVi was also observed after 24 months of FU.Ĭonclusions: His bundle pacing in permanently paced patients when LVEF is reduced below 50% is associated with improvement in LVEF and reverse left ventricle remodeling.Respiratory variations in the inferior vena cava diameter (ΔIVCD) have been studied extensively with respect to their value in predicting fluid responsiveness, but the results are conflicting. In 53.1%, the LVESVi reduction was greater than 15%. The mean age was 70.6 ± 9.23 years, and 79% were males. Eighty-two patients completed a 6-month FU. Results: His bundle pacing was successful in 154 (85.1%) patients. Pacing parameters and echocardiographic and clinical data were assessed for up to 2 years of follow-up (FU). The HBP indications were as follows: 1) bradycardia and atrioventricular conduction disturbances with expected high pacing burden, 2) IVCD, LVEF ≤ 35%, with an indication for resynchronization therapy, 3) the need to upgrade to resynchronization therapy due to pacing-induced cardiomyopathy. The patients had left ventricular ejection fraction (LVEF) < 50% and were implanted between November 2015 and April 2019. Methods: A total of 181 patients from the HBP registry were enrolled into a the study, which was conducted at the Department of Electrocardiology in Katowice, Poland. Background: His bundle pacing (HBP) maintains a physiological activation pattern of ventricular activation, and in patients with intraventricular conduction delay (IVCD) it can normalize wide QRS duration.
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