BUN/creatinine ratio and the inferior vena cava collapsibility index in ventilator associated pneumonia

Abstract

AimEvaluation of intravascular fluid status in critically ill patients is of significant importance. Many studies have suggested that measurement of the inferior vena cava diameter is useful for assessing volume status. In this study, we aimed to compare the efficacy of commonly used scoring systems, including APACHE II, SOFA, and CPIS, the BUN/creatinine ratio, and the inferior vena cava collapsibility index (IVC CI) in predicting mortality among patients diagnosed with ventilator-associated pneumonia (VAP).MethodFifty-seven patients with bacterial isolation from lower respiratory tract specimens were included in the study. Demographic characteristics, comorbid conditions, biochemical parameters, BUN/creatinine ratio, MDRD, APACHE II, SOFA, CPIS, and final patient outcomes were recorded.ResultsA statistically significant relationship was found between IVC CI and BUN/creatinine ratio (P = .003). A significant correlation was observed between MDRD and BUN/creatinine ratio (P < .001). A positive correlation was detected between procalcitonin and SOFA score (r = 0.618, P < .001). An increase in CPIS increased mortality risk by 3.52-fold (P = .027). Patients with an IVC CI value ≥50 had a 38.59-fold higher mortality risk compared with those with an IVC CI value <50 (P = .003).ConclusionProcalcitonin and CPIS may provide guidance for predicting mortality in patients with VAP. Calculation of the IVC CI value is considered a sensitive method for determining and monitoring fluid therapy in patients with VAP and in patients admitted to the intensive care unit.

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