Evaluatıon of Volume Status And Treatment Response With Point-of-Care Inferior Vena Cava Ultrasound in Patients With Gastrointestinal Bleeding

Backgraund: Gastrointestinal bleeding (GIB) is a medical problem with significant morbidity and mortality and high consumption of healthcare resources, and is one of the main reasons for consultation in emergency department (ED). In critically ill patients, measuring the Inferior Vena Cava (IVC) diameter by bedside ultrasonography helps in the evaluation of intravascular status. Objective: The aim of this study was to assess the association of point-of-care ultrasound (POCUS) used by emergency physicians to examine IVC diameter ratio in patients with GIB. Methods: A single-center prospective observational study was conducted on consecutive patients with GIB who presented to the ED. Epidemiological and clinical characteristics of the patients, laboratory results and pre- and post-treatment IVC diameter were measured. Patients were divided into two groups as upper GIB (UGIB) and lower GIB (LGIB) based on endoscopic data. Results: A total of 150 patients were included in our study. 39.3% of the patients were female, 60.7% were male, and the mean age was 59.25 ±19.91 (min: 19, max: 93). 77% (n=116) of the patients presented with UGIB, and 23% (n=34) with LGIB. In patients with UGIB, IVC MIN and IVC MAX values were significantly increased 2 hours after treatment (p<0.05); IVCCI value after 2 hours was statistically insignificant (p>0.05). In patients with LGIB, IVC MIN, IVC MAX and IVCCI were statistically insignificant in measurements taken 2 hours after treatment (p>0.05). IVC MIN and IVC MAX values of the entire group were significantly increased at the 2-hour measurement after treatment (p<0.05), however, IVCCI changes were statistically insignificant (p>0.05). Conclusion: The inferior vena cava diameter ratio was independently associated with a poor outcome in patients with GIB.