Key result
Ultrasound-guided inferior vena cava dispensability index was superior to central venous pressure for predicting fluid responsiveness (sensitivity 100% vs 50%) in shocked patients.
Why the study?
While central venous pressure is frequently used to guide fluid resuscitation in shocked patients, ultrasound-guided inferior vena cava measurements have emerged to assess volume status.
Does ultrasound-guided inferior vena cava dispensability index improve the prediction of hypovolemia and fluid responsiveness compared to central venous pressure in shocked patients?
Observational (n=60)
Yes
Does ultrasound-guided inferior vena cava dispensability index improve the prediction of hypovolemia and fluid responsiveness compared to central venous pressure in shocked patients?
Ultrasound-guided IVC dispensability index is superior to central venous pressure for predicting fluid responsiveness and hypovolemia in shocked ICU patients.
IVC ultrasound may noninvasively estimate volume status versus CVP; leaves open accuracy, interchangeability, and resuscitation guidance in shocked patients.
Background: The central venous pressure [CVP] remains the most frequently used variable to guide fluid resuscitation in shocked patients and is considered a direct measurement of the blood pressure in the right atrium and vena cava. The ultrasound-guided measurement of the inferior vena cava [IVC] and its changes with respiration has recently been utilized to calculate a patient's fluid status.The Aim of the work: This work aimed to compare ultrasound guided inferior vena cava dispensability index to central venous pressure in shocked patients and to assess the volume status in shocked patients after measurement of CVP and IVC dispensability index [IVC DI].Patients and Methods: The study was conducted on 60 shocked patients, who were selected from the ICU, Al-Azhar University Hospitals.Results: At cutoff point 7.5 cmH2O, CVP has a sensitivity of 97% and specificity of 96.3% for prediction of hypovolemia. Also, at cutoff point 15.5, IVC-DI has sensitivity of 93.9% and specificity of 100% to predict hypovolemia. In addition, CVP at cutoff point 8.5 cmH2O has sensitivity of 50% and specificity of 55% for predicting fluid responsiveness. Also, at cutoff point 14.5 IVC DI has sensitivity of 100% and specificity of 91.9% for predicting fluid responsiveness.Conclusion: Ultrasound guided CVP and IVC DI were reliable markers in predicting fluid responsiveness and hypovolemia among shocked patients. IVC DI was superior than central CVP.
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Alfatah et al. (2023) conducted an observational in Shock (n=60). Ultrasound-guided inferior vena cava dispensability index (IVC DI) vs. Central venous pressure (CVP) was evaluated on Prediction of hypovolemia and fluid responsiveness. Ultrasound-guided inferior vena cava dispensability index was superior to central venous pressure for predicting fluid responsiveness (sensitivity 100% vs 50%) in shocked patients.
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