Dynamic Monitoring and Evaluation of Volume Responsiveness and Prognosis in Patients with Septic Shock Based on NT-proBNP and Inferior Vena Cava Variability

FU Jun; LUO Yuhong; SUN Yuewen; WU Hairong; WU Xuejiang

PDF(2264 KB)

Journal of Hunan Normal University(Medical Science) ›› 2025, Vol. 22 ›› Issue (6) : 68-73.

FU Jun¹, LUO Yuhong², SUN Yuewen², WU Hairong², WU Xuejiang¹

Author information +

History +

Abstract

Objective To investigate the dynamic assessment value of N-terminal pro-brain natriuretic peptide (NT-proBNP) combined with inferior vena cava variability (IVC-RVI) for volume responsiveness and prognosis in patients with septic shock. Methods A retrospective analysis of 50 patients with septic shock admitted to the Department of Emergency, Wuxi Hospital of Traditional Chinese Medicine. All patients were treated with fluid resuscitation and divided into volume-responsive group (38 cases) and non-responsive group (12 cases) based on their volume responsiveness after treatment; and into survival group (34 cases) and death group (16 cases) based on their clinical outcomes after 28 days. Levels of NT-proBNP and IVC-RVI were measured before treatment and at 24 h and 72 h post-treatment; ROC curves were plotted to analyze the dynamic diagnostic value of NT-proBNP and IVC-RVI in volume responsiveness and clinical prognosis in patients with septic shock. Results Compared with the non-responsive group, the volume-responsive group had lower NT-proBNP levels and higher IVC-RVI levels before treatment, and the combined detection of NT-proBNP and IVC-RVI before treatment had a higher diagnostic value for volume responsiveness (AUC=0.798) than single indicators NT-proBNP (AUC=0.765) and IVC-RVI (AUC=0.770); Compared with the death group, the survival group had lower NT-proBNP levels and higher IVC-RVI levels before treatment and at 24 h and 72 h post-treatment, and the combined detection of NT-proBNP and IVC-RVI before treatment and at 24 h and 72 h post-treatment had a higher diagnostic value for clinical prognosis than single indicators, with the highest diagnostic value at 72 h post-treatment (AUC=0.972). Conclusion Low levels of NT-proBNP coupled with elevated IVC-RVI characterize septic shock patients with favorable volume responsiveness and improved clinical outcomes, while their integrated application demonstrates superior diagnostic performance.

Key words

N-terminal pro-brain natriuretic peptide / inferior vena cava variability / septic shock / volume responsiveness

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

FU Jun, LUO Yuhong, SUN Yuewen, WU Hairong, WU Xuejiang. Dynamic Monitoring and Evaluation of Volume Responsiveness and Prognosis in Patients with Septic Shock Based on NT-proBNP and Inferior Vena Cava Variability[J]. Journal of Hunan Normal University(Medical Science). 2025, 22(6): 68-73

References

[1] LIU Y C, YAO Y, YU MM, et al.Frequency and mortality of sepsis and septic shock in China: a systematic review and meta-analysis[J]. BMC Infect Dis, 2022, 22(1): 564.
[2] LONG B, GOTTLIEB M.Emergency medicine updates: management of sepsis and septic shock[J]. Am J Emerg Med, 2025, 90: 179-191.
[3] RAJDEV K, LEIFER L, SANDHU G, et al.Fluid resuscitation in patients with end-stage renal disease on hemodialysis presenting with severe sepsis or septic shock: a case control study[J]. J Crit Care, 2020, 55: 157-162.
[4] 杨利利, 景云烟, 林菊, 等. 床旁超声指导下早期液体复苏对脓毒症休克患者血流动力学及终点事件的影响[J]. 中华医院感染学杂志, 2024, 34(1): 134-138.
[5] CAVEFORS O, EINARSSON F, HOLMQVIST J, et al.Cardiac biomarkers for screening and prognostication of cardiac dysfunction in critically ill patients[J]. ESC Heart Fail, 2024, 11(6): 4009-4018.
[6] BAYES-GENIS A, DOCHERTY K F, PETRIE MC, et al.Practical algorithms for early diagnosis of heart failure and heart stress using NT-proBNP: a clinical consensus statement from the Heart Failure Association of the ESC[J]. Eur J Heart Fail, 2023, 25(11): 1891-1898.
[7] 余群锋, 叶晨曦, 俞啸, 等. 心脏超声联合下腔静脉变异度对感染性休克容量反应性的评估价值[J]. 中华医院感染学杂志, 2024(14): 2163-2167.
[8] 曹钰, 柴艳芬, 邓颖, 等. 中国脓毒症/脓毒性休克急诊治疗指南 (2018)[J]. 中国急救医学, 2018, 38(9): 741-756.
[9] QAYYUM S, SHAHID K.Fluid resuscitation in septic patients[J]. Cureus, 2023, 15(8): e44317.
[10] SHAHNOOR H, DIVI R, ADDI P L, et al.The effects of restrictive fluid resuscitation on the clinical outcomes in patients with sepsis or septic shock: a meta-analysis of randomized-controlled trials[J]. Cureus, 2023, 15(9): e45620.
[11] 张丽, 郑祥德, 田琳. 感染性休克液体复苏完成时限对病情转归的影响[J]. 临床误诊误治, 2024, 37(3): 83-88.
[12] 张士跃, 张庆, 刘春来, 等. 脓毒症休克患者血脂水平动态监测对预测短期预后的价值研究[J]. 现代检验医学杂志, 2024, 39(4): 72-75.
[13] 韩福星, 王高频. 沙库巴曲缬沙坦通过调控H-FABP, NT-proBNP和LVEF对心力衰竭伴房颤患者心功能, 心室重构的影响[J]. 中国老年学杂志, 2025(3): 517-521.
[14] GARCÍA-CARMONA JA, ONESA-GARCíA E, VIDAL-MENA D, et al. Increased plasma levels of N-terminal pro-B-type natriuretic peptide as biomarker for the diagnosis of cardioembolic ischaemic stroke[J]. Neurologia (Engl Ed), 2024, 39(6): 496-504.
[15] 张智玺, 韩雪, 何春来, 等. 下腔静脉塌陷指数与血浆NT-proBNP评价急性失代偿心力衰竭容量反应的价值[J]. 临床急诊杂志, 2018, 19(11): 4.
[16] YU G, HENG K, LIU Q, et al.Clinical outcomes of severe sepsis and septic shock patients with left ventricular dysfunction undergoing continuous renal replacement therapy[J]. Sci Rep, 2022, 12(1): 9360.
[17] SONG J, FANG X, ZHOU K, et al.Sepsis-induced cardiac dysfunction and pathogenetic mechanisms (Review)[J]. Mol Med Rep, 2023, 28(6): 227.
[18] 孟祥丽, 黄学玲, 张建玲, 等. 血NT-proBNP联合血流动力学监测对感染性休克患者预后的评估价值[J]. 中华医院感染学杂志, 2022, 32(5): 5.
[19] PERSICHINI R, LAI C, TEBOUL J L, et al.Venous return and mean systemic filling pressure: physiology and clinical applications[J]. Crit Care, 2022, 26(1): 150.
[20] 马雨, 尹云翔, 周艺蕉, 等. 脓毒性休克初始液体复苏的争议与研究进展[J]. 中国急救医学, 2023, 43(1): 70-75.