Key result
Ultrasound IVC diameter variation predicts fluid responsiveness in critically ill patients with ~0.86 AUC.
Why the study?
To evaluate the diagnostic accuracy of ultrasonographic diameter variation in the IVC, IJV, SCV, and FV for predicting fluid responsiveness in critically ill patients.
Does ultrasonographic respiratory variation in the IVC, IJV, SCV, and FV predict fluid responsiveness in critically ill patients?
Meta-Analysis (n=1,719)
Does ultrasonographic respiratory variation in the IVC, IJV, SCV, and FV predict fluid responsiveness in critically ill patients?
Ultrasonographic measurement of inferior vena cava respiratory variation provides favorable diagnostic accuracy for predicting fluid responsiveness in critically ill patients, regardless of mechanical ventilation status.
Supports bedside IVC ultrasound to guide fluid decisions in critically ill patients; confirms favorable diagnostic accuracy regardless of ventilation status.
This systematic review and meta-analysis aimed to investigate the ultrasonographic variation of the diameter of the inferior vena cava (IVC), internal jugular vein (IJV), subclavian vein (SCV), and femoral vein (FV) to predict fluid responsiveness in critically ill patients. Relevant articles were obtained by searching PubMed, EMBASE, and Cochrane databases (articles up to 21 October 2021). The number of true positives, false positives, false negatives, and true negatives for the index test to predict fluid responsiveness was collected. We used a hierarchical summary receiver operating characteristics model and bivariate model for meta-analysis. Finally, 30 studies comprising 1719 patients were included in this review. The ultrasonographic variation of the IVC showed a pooled sensitivity and specificity of 0.75 and 0.83, respectively. The area under the receiver operating characteristics curve was 0.86. In the subgroup analysis, there was no difference between patients on mechanical ventilation and those breathing spontaneously. In terms of the IJV, SCV, and FV, meta-analysis was not conducted due to the limited number of studies. The ultrasonographic measurement of the variation in diameter of the IVC has a favorable diagnostic accuracy for predicting fluid responsiveness in critically ill patients. However, there was insufficient evidence in terms of the IJV, SCV, and FV.
No takes yet. Share an insight, caveat, or question.
Kim et al. (2021) conducted a meta-analysis in critically ill patients (n=1,719). Ultrasonographic variation of inferior vena cava (IVC) diameter was evaluated on Prediction of fluid responsiveness (Sensitivity 0.75, Specificity 0.83, AUC 0.86). Ultrasonographic variation of the inferior vena cava diameter predicted fluid responsiveness in critically ill patients with a pooled sensitivity of 0.75, specificity of 0.83, and AUC of 0.86.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: