SHOCK最新文献

{"title":"MICRORNA-146B TARGETS HIF-1Α AND ATTENUATES CARDIOMYOCYTE APOPTOSIS AND FIBROSIS IN DOXORUBICIN-INDUCED HEART FAILURE.","authors":"Min Wang, Rui Lu, Liang Peng, Ling-Ling Xu, Shang-Fei He, Tao Guo, Ming-Jun Lu, Yi Luo, Tong-Tao Cui","doi":"10.1097/SHK.0000000000002546","DOIUrl":"10.1097/SHK.0000000000002546","url":null,"abstract":"<p><strong>Abstract: </strong>The global prevalence of heart failure is still growing, which imposes a heavy economic burden. The role of microRNA-146b (miR-146b) in HF remains largely unknown. This study aims to explore the role and mechanism of miR-146b in HF. Method: We applied reverse transcription-polymerase chain reaction to search for differential microRNAs between myocardial tissues of heart failure patients and controls. We also used reverse transcription-polymerase chain reaction to detect the miR-146b expression in primary neonatal mouse cardiomyocytes and mice models of doxorubicin-induced HF. In vivo experiments, echocardiography was performed at baseline and weeks 6. After that we harvested mice's heart and evaluated the cardiomyocyte with hematoxylin and eosin (HE), Masson trichrome staining, and TUNEL staining. Through bioinformatics analysis, we found HIF-1α might be the target gene of miR-146b, which validated by luciferase reporter gene assay. Subsequently, mRNA and protein expression levels of HIF-1α were detected by overexpression or inhibition of miR-146b in primary neonatal mouse cardiomyocytes. Results: We found that miR-146b expression was decreased in myocardial tissues of HF patients compared with controls ( P < 0.01). MiR-146b levels were notably downregulated in HF models. MiR-146b knockout mice showed a more pronounced decrease in cardiac function and more severe myocardial fibrosis and apoptosis than wild type. Meanwhile, over expression or repression of miR-146b in primary neonatal mouse cardiomyocytes could inhibit or upregulate HIF-1α mRNA and protein expression. Conclusion : Our study shows that miR-146b may be a protective factor for cardiomyocytes by modulating HIF-1α.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"656-663"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFECT AND REGULATORY MECHANISM OF SIRT6 ON POSTCARDIAC ARREST BRAIN INJURY IN RATS.","authors":"Jianxiong Liu, Li Zhen, Dihua Yu, Weiqing Wang","doi":"10.1097/SHK.0000000000002545","DOIUrl":"10.1097/SHK.0000000000002545","url":null,"abstract":"<p><strong>Abstract: </strong>Aims: Brain injury occupies the predominant cause of neurological dysfunction and mortality after successful cardiopulmonary resuscitation (CPR) from cardiac arrest (CA). This study investigates the role and mechanism of Sirtuin 6 (SIRT6) in postcardiac arrest brain injury in rats. Methods: All rats were subjected to asphyxial CA followed by CPR. Two weeks before modeling, rats were infected with lentivirus containing oe-SIRT6 and oe-FOXO1 through lateral ventricular injection. qRT-PCR and Western blot quantified SIRT6 and FOXO1 expressions in brain tissues. Neurological deficit scores evaluated the neural function of rats at different time points, and Water Maze Test assessed the changes in short-term learning and memory abilities. The survival status of rats 7 days after modeling was recorded. The pathological changes in brain tissues, inflammatory factors, and apoptosis were evaluated by H&E staining, ELISA, and TUNEL, respectively. Ch-IP measured the enrichment of SIRT6 and H3K9ac in the FOXO1 promoter. Results: SIRT6 was poorly expressed while FOXO1 was highly expressed in CA/CPR rats. Elevation of SIRT6 expression alleviated neural function, behavioral ability, and survival rate, as well as abated pathological damage, inflammatory responses, and cell apoptosis in CA/CPR rats. Mechanistically, SIRT6 curbed FOXO1 transcription and expression by lowering the H3K9ac level in the FOXO1 promoter; FOXO1 overexpression abolished the improvement effect of SIRT6 overexpression on brain injury in CA/CPR rats. Conclusions: Elevation of SIRT6 expression restrained the FOXO1 expression by diminishing the H3K9ac level in the FOXO1 promoter, thereby mitigating postcardiac arrest brain injury in rats.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"648-655"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CONSTRUCTING A DIAGNOSTIC PREDICTION MODEL TO ESTIMATE THE SEVERE RESPIRATORY SYNCYTIAL VIRUS PNEUMONIA IN CHILDREN BASED ON MACHINE LEARNING.","authors":"Yuanwei Liu, Qiong Wu, Lifang Zhou, Yingyuan Tang, Fen Li, Shuangjie Li","doi":"10.1097/SHK.0000000000002472","DOIUrl":"10.1097/SHK.0000000000002472","url":null,"abstract":"<p><strong>Abstract: </strong>Background : Severe respiratory syncytial virus (RSV) pneumonia is a leading cause of hospitalization and morbidity in infants and young children. Early identification of severe RSV pneumonia is crucial for timely and effective treatment by pediatricians. Currently, no prediction model exists for identifying severe RSV pneumonia in children. Methods : This study aimed to construct a diagnostic prediction model for severe RSV pneumonia in children using a machine learning algorithm. We analyzed data from the Gene Expression Omnibus (GEO) Series, including training dataset GSE246622 and testing dataset GSE105450, to identify differential genes between severe and mild-to-moderate RSV pneumonia in children. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the differential genes, followed by the construction of a protein-protein interaction network. An artificial neural network (ANN) algorithm was then used to develop and validate a diagnostic prediction model for severe RSV pneumonia in children. Results : We identified 34 differentially expressed genes between the severe and mild-to-moderate RSV pneumonia groups. Enrichment analysis revealed that these genes were primarily related to pathogenic infection and immune response. From the protein-protein interaction network, we identified 10 hub genes and, using the random forest algorithm, screened out 20 specific genes. The ANN-based diagnostic prediction model achieved an area under the curve value of 0.970 in the training group and 0.833 in the testing group, demonstrating the model's accuracy. Conclusions : This study identified specific biomarkers and developed a diagnostic model for severe RSV pneumonia in children. These findings provide a robust foundation for early identification and treatment of severe RSV pneumonia, offering new insights into its pathogenesis and improving pediatric care.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"533-540"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Admission Bariatric Surgery is Associated with Reduced Mortality in Surgical Patients with Sepsis.","authors":"Anahita Jalilvand, Patrick J Kennedy, John Loftus, Courtney Collins, Whitney Kellett, Wendy Wahl, Jon Wisler","doi":"10.1097/SHK.0000000000002568","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002568","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with higher 90-day mortality compared to non-obese surgical patients. Bariatric surgery (BS) can reduce obesity-related comorbidities, even in those with persistent obesity.</p><p><strong>Objective: </strong>Evaluate the impact of prior BS on sepsis outcomes in surgical patients with obesity.SettingUniversity Hospital, United States.</p><p><strong>Methods: </strong>A single institution retrospective review of all surgical patients with sepsis (SOFA≥2) was conducted. Patients were grouped into people with obesity and prior BS (OB/BS, n = 48), people with obesity without BS (OB, n = 717), non-obese (NOB, n = 574), and non-obese with prior BS (NOB/BS, n = 27). Demographic data, comorbidities, and sepsis presentation were compared. The primary outcome was cumulative 90-day mortality and survival.</p><p><strong>Results: </strong>Most OB/BS patients underwent gastric bypass <5 years from admission (61%). The OB/BS group was younger, more likely to be female, and transferred from an outside hospital. The mean BMI was highest in the OB/BS group (46.3±14.7, p < 0.0005). Charlson Comorbidity Index was lower in the OB/BS and NOB/BS groups (2 (1-4) and 2(2-4) respectively, p = 0.0033). Cumulative 90-day mortality was significantly lower in the OB/BS cohort (20.8%, p = 0.002). The OB/BS cohort was more likely to die from intra-abdominal sepsis not amenable to source control (60% vs 22.5% vs 22.8% vs 37.5%, p = 0.04). Compared to the other groups, 90-day survival was highest in the OB/BS cohort (logrank p < 0.009).</p><p><strong>Conclusions: </strong>This study demonstrated improvement in 90-day survival in OB/BS patients despite higher BMIs. However, this group was more likely to die from intra-abdominal sources, likely reflecting surgical complexity in the setting of prior bypasses.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questions Regarding Sampling and Validation Methods.","authors":"Tyler Zander, Melissa A Kendall, Rachel L Wolansky, Joseph Sujka, Paul C Kuo","doi":"10.1097/SHK.0000000000002580","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002580","url":null,"abstract":"","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methane administration during oxygenation mitigates acute kidney injury in a pig model of 24-hour veno-venous extracorporeal membrane oxygenation.","authors":"Noémi Vida, Zoltán Varga, Antal Szabó-Biczók, Gábor Bari, Gyöngyvér Vigyikán, Ádám Hodoniczki, Ámos Gajda, Attila Rutai, László Juhász, Szabolcs Péter Tallósy, Sándor Túrkevi-Nagy, Anett Bársony, Nándor Öveges, Andrea Szabó, Mihály Boros, Gabriella Varga, Dániel Érces","doi":"10.1097/SHK.0000000000002586","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002586","url":null,"abstract":"<p><strong>Background: </strong>Severe respiratory failure often requires veno-venous extracorporeal membrane oxygenation (v-v ECMO) treatment, a procedure frequently associated with acute kidney injury (AKI). Preclinical studies have demonstrated the anti-inflammatory properties of inhaled methane (CH4). This experimental protocol aimed to investigate whether CH4 gas administration could mitigate the development of AKI in a clinically relevant large animal model of v-v ECMO.</p><p><strong>Methods: </strong>Anesthetized miniature pigs were divided into three groups (n = 6 each). Following cannulation of the right femoral and internal jugular veins, v-v ECMO was initiated and maintained for 24 hours, followed by a 6-hour post-ECMO observation. The control group underwent cannulation without ECMO, while the v-v ECMO+CH4 group received a 2% CH4-air mixture via the oxygenator. Urine output was recorded, and kidney injury was assessed using plasma and urine neutrophil gelatinase-associated lipocalin (NGAL) levels. Inflammatory activation was evaluated through plasma interleukin-1β (IL-1β) and interleukin-8 (IL-8) levels. Kidney tissue samples were analyzed for histopathological changes, xanthine oxidoreductase (XOR) and myeloperoxidase (MPO) activities, and nitrite/nitrate (NOx) levels.</p><p><strong>Results: </strong>The CH4-treated group exhibited significantly higher post-ECMO renal arterial flow (244.7 ± 70 vs 96.3 ± 21 mL/min) and increased average urine output (5.75 ± 1.6 vs 3.25 ± 0.4 mL/h/kg) compared to the v-v ECMO group. CH4 administration reduced urine and plasma NGAL levels and demonstrated lower histological damage scores (0.8 ± 0.3 vs 3.3 ± 0.8). Furthermore, CH4 treatment decreased XOR and MPO activities and reduced inflammatory mediators, including IL-1β, IL-8, and NOx.</p><p><strong>Conclusion: </strong>CH4 admixture significantly mitigates inflammatory activation and renal injury associated with v-v ECMO. These findings suggest that CH4 may serve as an effective adjunctive means to reduce renal complications of v-v ECMO therapy.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors and Outcomes of Acute Kidney Injury in Intracerebral Hemorrhage Patients: Evidence from a Large-Scale National Database Analysis.","authors":"Binbin Tian, Xuanhe Tang, Linling He, Junfen Cheng, Jian Wang, Silin Liang, Junde Mo, Chunbo Chen","doi":"10.1097/SHK.0000000000002577","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002577","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a significant complication in patients with intracerebral hemorrhage (ICH). This study sought to explore the incidence, risk factors, and outcomes of AKI in ICH patients using a comprehensive national database.</p><p><strong>Methods: </strong>Data from the Nationwide Inpatient Sample database (2010-2019) were analyzed. This analysis compared demographics, comorbidities, complications, mortality, and healthcare utilization between ICH patients who developed AKI and those who did not. Multivariate logistic regression was used to identify risk factors for AKI and assess their impact on in-hospital outcomes.</p><p><strong>Results: </strong>The incidence of AKI among ICH patients increased from 10.7% in 2010 to 19.6% by 2019, yielding an overall incidence rate of 15%. Risk factors included, Black race, comorbidities (≥ 3), teaching hospital setting, and specific pre-existing conditions such as heart failure, coagulopathy, diabetes, fluid and electrolyte disorders, other neurological disorders, obesity, paralysis, chronic kidney disease excluding ESRD, peptic ulcer disease (without bleeding), and weight loss. Conversely, female sex and elective admissions acted as protective factors. AKI-related in-hospital complications encompassed acute myocardial infarction, pneumonia, sepsis, cardiac arrest, respiratory failure, and mechanical ventilation. AKI was associated with higher in-hospital mortality (26.9% vs. 18.5%), prolonged hospital stays (median duration of 9 days vs. 5 days for non-AKI patients) and increased requirement for dialysis (3.1% vs. 0.0%). Healthcare costs were significantly elevated, with median charges doubling for AKI patients.</p><p><strong>Conclusion: </strong>AKI is a frequent and severe complication among patients with ICH, markedly influencing clinical outcomes and healthcare resource utilization. Early identification of high-risk patients and implementation of effective preventive strategies are critical to enhance patient management and outcomes.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PROGESTERONE TREATMENT POSITIVE EFFECTS IN THE FUNCTION AND INFLAMMATION OF INTESTINE COMPROMISED BYAORTIC OCCLUSION.","authors":"Brunella Valbão Flora Agostinho, Pedro Luiz Zonta de Freitas, Ivana Ramires Fraga, Lucas Ferreira da Anunciação, Fernanda Yamamoto Ricardo-da-Silva, Ana Cristina Breithaupt-Faloppa, Cristiano Jesus Correia, Luiz Felipe Pinho Moreira","doi":"10.1097/SHK.0000000000002595","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002595","url":null,"abstract":"<p><strong>Methods: </strong>Male Wistar rats were randomized to 4 groups: Sham, surgically manipulated; IR, animals subjected to I/R; P4 Pre, animals treated with P4 30 minutes before I/R and P4 Post, treated immediately after flow reestablishment. I/R was induced by catheter 2F insufflation in the descending aorta, occluded for 30 min, followed by reperfusion for 2 h. Intestinal function, inflammatory and apoptosis markers, and mesenteric microcirculation were analyzed.</p><p><strong>Results: </strong>Aortic occlusion led to systemic changes and intestinal homeostasis disruption. The I/R decreased the gastrointestinal transit (Sham 69%, IR 46%; P = 0.0014) and the progesterone reduced impact induced by I/R (IR 46%, P4 Post 60%; P = 0.0461). The treatment prevented the increase of epithelial mucosal barrier permeability and edema formation triggered by I/R (Sham 0.2770 ng/mL vs I/R 5.455 ng/mL; P = 0.0048) and (P4 Pre 2.027 ng/mL; P = 0.0393). It also reduced inflammatory cell infiltration to intestinal tissue (IR 0.5876 vs P4 Pre 0.1818; P = 0.0003 and P4 Post 0.1393 stained area/tissue area; P < 0.0001), modulating the release of inflammatory mediators and apoptosis markers (IR 0.1806 vs P4 Pre 0.0468; P = 0.0452).</p><p><strong>Conclusion: </strong>Progesterone treatment was effective in modulating the neutrophil response and other inflammatory markers, decreased apoptosis, and improved gastrointestinal function triggered by I/R.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramuscular Terlipressin as Monotherapy for Early Management of Uncontrolled Traumatic Hemorrhagic Shock: A Preliminary Study.","authors":"Shouyin Jiang, Ximei Ma, Taiwen Rao, Xiangkang Lv, Bojin Chen, Xiaogang Zhao, Shanxiang Xu","doi":"10.1097/SHK.0000000000002594","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002594","url":null,"abstract":"<p><strong>Abstract: </strong>Monotherapy using a single-dose vasopressor to maintain essential organ perfusion could be a viable alternative to restrictive fluid resuscitation in uncontrolled traumatic hemorrhagic shock (UTHS). This study evaluated the impact of intramuscular terlipressin on hemodynamics and organ injuries in UTHS. Adult male Sprague-Dawley rats, with eight rats in each group, were assigned to six distinct groups. Immediately after randomization, the rats in each group were exposed or not exposed to specific interventions over a 60-minute period, as follow: Sham, Shock, intramuscular terlipressin (5 μg/100 g), intravenous terlipressin (10 μg/100 g), normal saline (1.5 ml/100 g), and norepinephrine (0.3 μg/kg/min). The UTHS model was created by midline laparotomy, femoral artery bleeding, and tail amputation. After surgical hemostasis, resuscitated rats had a one-hour infusion of lost blood. Invasive blood pressure comparations and organ injury assessments were performed. Mean arterial pressure was increased starting 8 minutes post-intramuscular injection of terlipressin. The systemic perfusion pressure from intramuscular terlipressin was notably higher than that from normal saline and norepinephrine after 40 and 70 minutes, respectively. In comparison with rats treated with normal saline and norepinephrine, those receiving intramuscular terlipressin demonstrated improvements in biomarkers related to microcirculation dysfunction. Although there were no significant differences in multi-organ function markers among the groups, intramuscular terlipressin led to improvements in the pathological injury scores of the muscle, intestine, and kidney. Collectively, intramuscular administration of terlipressin improved early hemodynamics and multi-organ pathological injuries post-UTHS. Future investigations are warranted to elucidate the molecular mechanisms underpinning the protective effects of this treatment.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Ultrasonic Cardiac Output Monitor in Evaluating Stroke Volume Variation to Determine Fluid Responsiveness in Patients with Shock.","authors":"Seval Orman, Pervin Hancı, Serdar Efe, Volkan İnal","doi":"10.1097/SHK.0000000000002584","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002584","url":null,"abstract":"<p><strong>Background: </strong>Dynamic assessment of cardiac output (CO) with passive leg raise (PLR), stroke volume variation (SVV), and pulse pressure variation (PPV) offer effective and safe methods to predict fluid responsiveness in patients with shock. The primary aim of this study was to evaluate the reliability of CO and SVV readings with the Ultrasonic Cardiac Output Monitor (USCOM) 1A device compared to PPV measurements in determining fluid responsiveness of patients in shock.</p><p><strong>Materials and method: </strong>Intubated and mechanically ventilated patients aged 18-95 with shock admitted to the medical intensive care unit from June 2019 to December 2020 were included in the study. Fluid responsiveness was assessed using PPV from arterial monitoring and CO/SVV using the USCOM 1A device. CO, PPV, and SVV data were recorded before and after PLR.</p><p><strong>Results: </strong>Out of 145 shock patients, 92 were included. Before the PLR maneuver, 67 patients had PPV values above 12% and were stated as fluid responsive. The SVV index measured by the USCOM device demonstrated good sensitivity (85%) and specificity (96%) in identifying fluid responsiveness. The agreement with PPV was substantial [Cronbach's alpha reliability: 0.718 (p < 0.001)], and the index was internally consistent [kappa agreement: 0.707 (p < 0.001)]. The SVV index moderately correlated with PPV [R: 0.588 (p: 0.001). Regarding fluid responsiveness determined by PPV, the AUC value of SVV was 0.797 (0.701-0.894) (p: 0.001).</p><p><strong>Conclusion: </strong>SVV measured by the USCOM device is a reliable and practical tool for hemodynamic assessment in clinical practice, particularly when invasive methods are unsuitable.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}