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

Abstract

Aim: The evaluation of the intravascular fluid status of critical patients is of significant importance. Many publications that suggest that measurement of the inferior vena cava diameter is successful in indicating volume status are available. In this study, we aimed to compare the efficacy of the commonly used scoring systems APACHE II, SOFA, and CPIS, the BUN/Cre ratio, and the inferior vena cava collapsibility index (IVC CI) in terms of mortality prediction among patients diagnosed with VAP. Material and Method: Fifty-seven patients who had bacteria isolation in the specimens of the lower respiratory tract were included in the study. The demographic characteristics, comorbid conditions of all patients were recorded. In addition, the biochemical parameters, BUN/Cre ratio, MDRD, APACHE II, SOFA, CPIS, and the final status of each patient were recorded. Results: There was a statistically significant relationship between IVC CI and BCR (p=0.003). A significant correlation was found between MDRD and BCR (p < 0.001). There was a positive correlation between procalcitonin and SOFA score (r=0.618, p < 0.001). An increase in the CPIS value increases mortality to 3.52 times (p =0.027). The mortality risk of those with an IVC CI value of 50 and above is 38.59 times greater than that of those with an IVC CI value below 50 (p=0.003). Discussion: Procalcitonin and CPIS may provide guidance for predicting mortality in patients with VAP. We believe that the calculation of the IVC CI value is a sensitive method for determining and monitoring fluid therapy in patients with VAP and in every patient admitted to the ICU.