Ultrasound Dynamic Monitoring of The Inner Diameter of The Inferior Vena Cava To Guide The Application of Continuous Renal Replacement Therapy In Patients With Renal Failure Combined With Acute Heart Failure

Objective To explore the application value of bedside ultrasound dynamic monitoring of inferior vena cava diameter (IVCD) and collapse with sniff (IVCCI) to guide the application value of dehydration adjustment in continuous renal replacement therapy (CRRT) in patients with renal failure combined with acute heart failure. Methods We selected 90 patients with renal failure and acute heart failure who required continuous renal replacement therapy in the intensive care unit from January 2019 to June 2021. According to different blood volume assessment methods, patients were randomly divided into the ultrasound group, the experience group, and the control group. The inspection indicators of creatinine, K+, and NT-proBNP, the clinical indicators of improvement time of heart failure, time of continuous renal replacement therapy, use time of ventilator, ICU hospitalization time, and use time of vasopressor use and the incidence of adverse event were compared among the three groups. Results There were no significant differences in creatinine, K+, and NT-proBNP between the three groups before and after treatment (P>0.05). The improvement time of heart failure, time of continuous renal replacement therapy, and ICU hospitalization time in the ultrasound and experience group were lower than the control group, and the difference between the groups was statistically significant (P<0.05). The use time of ventilator in the ultrasound and experience group was lower than the control group, there was a statistically significant difference between the ultrasound group and the control group (P<0.05). The use time of vasopressor in the ultrasound group and the control group was lower than the experience group, and the difference between the groups was a statistically significant time(P<0.05). The incidence of adverse events in the ultrasound group was lower than the experience group and the control group, and the difference between the groups was a statistically significant time(P<0.05). Conclusion Ultrasound dynamic monitoring of inferior vena cava diameter and collapse with sniff can more accurately assess the blood volume status, and provide a better guidance effect for the accurate dehydration of continuous renal replacement therapy and the rapid relief of heart failure symptoms in patients with renal failure and acute heart failure.