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Measurement of the vascular pedicle width predicts fluid repletion: a cross-sectional comparison with inferior vena cava ultrasound and lung comets

Overview of attention for article published in Journal of Intensive Care, December 2015
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Title
Measurement of the vascular pedicle width predicts fluid repletion: a cross-sectional comparison with inferior vena cava ultrasound and lung comets
Published in
Journal of Intensive Care, December 2015
DOI 10.1186/s40560-015-0121-4
Pubmed ID
Authors

Nawal Salahuddin, Iqbal Hussain, Hakam Alsaidi, Quratulain Shaikh, Mini Joseph, Hassan Hawa, Khalid Maghrabi

Abstract

Determination of a patient's volume status remains challenging. Ultrasound assessments of the inferior vena cava and lung parenchyma have been shown to reflect fluid status when compared to the more traditional static and dynamic methods. Yet, resource-limited intensive care units (ICUs) may still not have access to bedside ultrasound. The vascular pedicle width (VPW) measured on chest radiographs remains underutilized for fluid assessment. In this study, we aimed to determine the correlation between ultrasound assessment and vascular pedicle width and to identify a discriminant value that predicted a fluid replete state. Eighty-four data points of simultaneous VPW and inferior vena cava measurements were collected on mechanically ventilated patients. VPW measurements were compared with lung comet scores, fluid balance, and a composite variable of inferior vena cava diameter greater than or equal to 2 cm and variability less than 15 %. A VPW of 64 mm accurately predicted fluid repletion with a positive predictive value equal to 88.5 % and an area under the curve (AUC) of 0.843, 95 % CI 0.75-0.93, p < 0.001. VPW closely correlated with inferior vena cava diameter (Pearson's r = 0.64, p = <0.001). Poor correlations were observed between VPW and lung comet score, Pearson's r = 0.12, p = 0.26, fluid balance, Pearson's r = 0.3, p = 0.058, and beta natriuretic peptide, Pearson's r = 0.12, p = 0.26. This study shows a high predictive ability of the VPW for fluid repletion, as compared to an accepted method of volume assessment. Given the relationship of fluid overload and mortality, these results may assist fluid resuscitation in resource-limited intensive care units.

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Mendeley readers

The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 3%
Unknown 39 98%

Demographic breakdown

Readers by professional status Count As %
Other 6 15%
Student > Postgraduate 6 15%
Student > Bachelor 3 8%
Librarian 3 8%
Researcher 3 8%
Other 11 28%
Unknown 8 20%
Readers by discipline Count As %
Medicine and Dentistry 21 53%
Nursing and Health Professions 3 8%
Biochemistry, Genetics and Molecular Biology 2 5%
Pharmacology, Toxicology and Pharmaceutical Science 1 3%
Environmental Science 1 3%
Other 2 5%
Unknown 10 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 January 2016.
All research outputs
#5,225,843
of 6,992,211 outputs
Outputs from Journal of Intensive Care
#117
of 142 outputs
Outputs of similar age
#207,462
of 302,620 outputs
Outputs of similar age from Journal of Intensive Care
#13
of 18 outputs
Altmetric has tracked 6,992,211 research outputs across all sources so far. This one is in the 14th percentile – i.e., 14% of other outputs scored the same or lower than it.
So far Altmetric has tracked 142 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.6. This one is in the 5th percentile – i.e., 5% of its peers scored the same or lower than it.
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