Can Left ventricular outflow tract aortic velocity time integral guide fluid resuscitation in septic patients? - A case report

  • Livio Colombo | liviocolombo@me.com Pronto Soccorso - DEA Ospedale SantiPaoloCarlo, Presidio San Paolo, Milan, Italy.
  • Francesco Panizzardi Pronto Soccorso - DEA Ospedale SantiPaoloCarlo, Presidio San Paolo, Milan, Italy.
  • Irene Rusconi Pronto Soccorso - DEA Ospedale SantiPaoloCarlo, Presidio San Paolo, Milan, Italy.
  • Anna Roncoroni Pronto Soccorso - DEA Ospedale SantiPaoloCarlo, Presidio San Paolo, Milan, Italy.
  • Marta Bergamaschi Pronto Soccorso - Medicina d’Urgenza Ospedale Niguarda, Milan, Italy.
  • Alfredo Macheda Pronto Soccorso - DEA Ospedale SantiPaoloCarlo, Presidio San Paolo, Milan, Italy.

Abstract

Hemodynamic monitoring of unstable patients is an everyday issue for Emergency Physicians (EP). Considering the difficulty, in Emergency Department (ED) settings, to assess invasively Stroke Volume (SV), Cardiac Output (CO) and Peripheral Vascular Resistance (PVR), EP should be familiar with non-invasive, easy and reproducible methods that can estimate these parameters. The use of Left Ventricular Outflow Tract aortic Velocity Time Integral (LVOT-VTI) with echocardiography, as estimate of SV, integrated with inferior vena cava collapse index and clinical examination could give the opportunity to non-invasively understand at which point of an ideal cardiac output/central venous pressure relation (according to the Frank Starling law) the patient is situated. In this case report we describe a septic patient accessing the ED with both respiratory and cardiac failure, and we show that the use of aortic LVOT-VTI is an easy and reproducible approach to understand cardiac hemodynamic in scenarios involving multiple pathologic mechanisms.

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Published
2020-08-25
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Section
Case Reports
Keywords:
Aortic velocity time integral, unstable patients, hemodynamic monitoring
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How to Cite
Colombo, L., Panizzardi, F., Rusconi, I., Roncoroni, A., Bergamaschi, M., & Macheda, A. (2020). Can Left ventricular outflow tract aortic velocity time integral guide fluid resuscitation in septic patients? - A case report. Emergency Care Journal, 16(2). https://doi.org/10.4081/ecj.2020.8817