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Sonographic Assessment of Intravascular Fluid Estimate (SAFE) Score by Using Bedside Ultrasound in the Intensive Care Unit.
Crit Care Res Pract. 2020; 2020:9719751.CC

Abstract

Objective

The objective of the study was to use an ultrasound-based numerical scoring system for assessment of intravascular fluid estimate (SAFE) and test its validity.

Methods

A prospective, observational study was carried out in the surgical intensive care unit (ICU) of an urban tertiary care teaching hospital. Patient's intravascular volume status was assessed using the standard methods of heart rate, blood pressure, central venous pressure, cardiac output, lactate and saturation of venous oxygen, and others. This was compared with assessment using bedside ultrasound evaluation of the cardiac function, inferior vena cava, lungs, and the internal jugular vein. Applying a numerical scoring system was evaluated by Fisher's exact testing and multinomial logistic model to predict the volume status based on ultrasound scores and the classification accuracy.

Results

61 patients in the ICU were evaluated. 21 (34.4% of total) patients diagnosed with hypovolemia, and their ultrasound volume score was -4 in 14 (66.7%) patients, -3 in 5 (23.8%) patients, and 0 in 2 (9.5%) patients (p < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient (p < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient (p < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient (p < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient (.

Conclusion

Using the SAFE scoring system to identify the IVV status in critically ill patients significantly correlates with the standard measures. A SAFE score of -4 to -2 more likely represents hypovolemia, -1 to +1 more likely represents euvolemia, and +2 to +4 more likely to be hypervolemia.

Authors+Show Affiliations

Department of Surgery, Division of Acute Care Surgery, Henry Ford Hospital, Detroit, MI, USA. Keck School of Medicine, Department of Medicine, Division of Pulmonary, Critical Care, Sleep Medicine, University of Southern California, Los Angeles, CA, USA.Department of Surgery, Division of Acute Care Surgery, Henry Ford Hospital, Detroit, MI, USA.Department of Surgery, Division of Acute Care Surgery, Henry Ford Hospital, Detroit, MI, USA.Medical College of Wisconsin, Department of Minimally Invasive and General Surgery, Wauwatosa, WI, USA.Department of Surgery, Division of Acute Care Surgery, Henry Ford Hospital, Detroit, MI, USA.Department of Surgery, Division of Acute Care Surgery, Henry Ford Hospital, Detroit, MI, USA.Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32185080

Citation

Killu, Keith, et al. "Sonographic Assessment of Intravascular Fluid Estimate (SAFE) Score By Using Bedside Ultrasound in the Intensive Care Unit." Critical Care Research and Practice, vol. 2020, 2020, p. 9719751.
Killu K, Coba V, Blyden D, et al. Sonographic Assessment of Intravascular Fluid Estimate (SAFE) Score by Using Bedside Ultrasound in the Intensive Care Unit. Crit Care Res Pract. 2020;2020:9719751.
Killu, K., Coba, V., Blyden, D., Munie, S., Dereczyk, D., Kandagatla, P., & Tang, A. (2020). Sonographic Assessment of Intravascular Fluid Estimate (SAFE) Score by Using Bedside Ultrasound in the Intensive Care Unit. Critical Care Research and Practice, 2020, 9719751. https://doi.org/10.1155/2020/9719751
Killu K, et al. Sonographic Assessment of Intravascular Fluid Estimate (SAFE) Score By Using Bedside Ultrasound in the Intensive Care Unit. Crit Care Res Pract. 2020;2020:9719751. PubMed PMID: 32185080.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sonographic Assessment of Intravascular Fluid Estimate (SAFE) Score by Using Bedside Ultrasound in the Intensive Care Unit. AU - Killu,Keith, AU - Coba,Victor, AU - Blyden,Dionne, AU - Munie,Semeret, AU - Dereczyk,Darlene, AU - Kandagatla,Pridvi, AU - Tang,Amy, Y1 - 2020/02/24/ PY - 2019/06/21/received PY - 2020/01/06/revised PY - 2020/02/01/accepted PY - 2020/3/19/entrez PY - 2020/3/19/pubmed PY - 2020/3/19/medline SP - 9719751 EP - 9719751 JF - Critical care research and practice JO - Crit Care Res Pract VL - 2020 N2 - Objective: The objective of the study was to use an ultrasound-based numerical scoring system for assessment of intravascular fluid estimate (SAFE) and test its validity. Methods: A prospective, observational study was carried out in the surgical intensive care unit (ICU) of an urban tertiary care teaching hospital. Patient's intravascular volume status was assessed using the standard methods of heart rate, blood pressure, central venous pressure, cardiac output, lactate and saturation of venous oxygen, and others. This was compared with assessment using bedside ultrasound evaluation of the cardiac function, inferior vena cava, lungs, and the internal jugular vein. Applying a numerical scoring system was evaluated by Fisher's exact testing and multinomial logistic model to predict the volume status based on ultrasound scores and the classification accuracy. Results: 61 patients in the ICU were evaluated. 21 (34.4% of total) patients diagnosed with hypovolemia, and their ultrasound volume score was -4 in 14 (66.7%) patients, -3 in 5 (23.8%) patients, and 0 in 2 (9.5%) patients (p < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient (p < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient (p < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient (p < 0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and -1 in 1 (5.6%) patient (. Conclusion: Using the SAFE scoring system to identify the IVV status in critically ill patients significantly correlates with the standard measures. A SAFE score of -4 to -2 more likely represents hypovolemia, -1 to +1 more likely represents euvolemia, and +2 to +4 more likely to be hypervolemia. SN - 2090-1305 UR - https://www.unboundmedicine.com/medline/citation/32185080/Sonographic_Assessment_of_Intravascular_Fluid_Estimate_(SAFE)_Score_by_Using_Bedside_Ultrasound_in_the_Intensive_Care_Unit L2 - https://dx.doi.org/10.1155/2020/9719751 DB - PRIME DP - Unbound Medicine ER -
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