Inferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure

Abstract Background Assessing fluid responsiveness is the key to successful resuscitation of critically-ill sepsis patients. The use of IVC variation is favored among the dynamic methods of fluid responsiveness assessment in the ICU because it is non-invasive and inexpensive; moreover, it does not d...

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Autores principales:	Ahmed Ibrahim Nagi, Azza Mohamed Shafik, Amr Mohamed Abdel Fatah, Wessam Zaher Selima, Amira Fathy Hefny
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Inferior vena cava collapsibility index IVC max IVC min Ultrasonography Echocardiography Stroke volume Anesthesiology RD78.3-87.3 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/ade9bed7dcc94c63ba45e83cc1153f3a
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spelling	oai:doaj.org-article:ade9bed7dcc94c63ba45e83cc1153f3a2021-11-28T12:06:33ZInferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure10.1186/s42077-021-00194-y2090-925Xhttps://doaj.org/article/ade9bed7dcc94c63ba45e83cc1153f3a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s42077-021-00194-yhttps://doaj.org/toc/2090-925XAbstract Background Assessing fluid responsiveness is the key to successful resuscitation of critically-ill sepsis patients. The use of IVC variation is favored among the dynamic methods of fluid responsiveness assessment in the ICU because it is non-invasive and inexpensive; moreover, it does not demand a high level of training. The aim of this study is to determine the value of the IVC respiratory variability for predicting fluid responsiveness in spontaneously breathing sepsis patients with acute circulatory failure. Results In this prospective observational study, fifty-eight spontaneously breathing sepsis patients admitted in the ICU were enrolled after the approval of the departmental Research Ethical Committee, and the informed written consent had been taken from the patients. Ultrasonographic and echocardiographic parameters were measured “IVC parameters and stroke volume (SV)” with calculation of the inferior vena cava collapsibility index (IVCCI) and cardiac output. These values were obtained before (baseline) and after volume expansion with a fluid bolus. The study showed that twenty-nine patients (50%) were considered to be responders, with an increase in CO by 10% or more after fluid challenge. There was a significant difference between responders and non-responders in baseline IVCCI (p value < 0.001). There were no significant differences between responders and non-responders in terms of demographic and baseline clinical characteristics. Also, there was statistically significantly larger maximum (IVC max) and minimum (IVC min) inferior vena cava diameters before volume expansion in non-responders than in responders with p value 0.037 and 0.001 respectively. The suggested cut off value regarding baseline IVCCI to predict response to fluid infusion is 0.32 with a high chance of response above this figure (a sensitivity of 72.41% and a specificity of 82.76%). Conclusions Inferior vena cava collapsibility index assessment can be a sensitive and a good predictor of fluid responsiveness, being based on a safe and a non-invasive technique compared to other methods such as central venous pressure (CVP) measurement and pulmonary artery catheter insertion.Ahmed Ibrahim NagiAzza Mohamed ShafikAmr Mohamed Abdel FatahWessam Zaher SelimaAmira Fathy HefnySpringerOpenarticleInferior vena cava collapsibility indexIVC maxIVC minUltrasonographyEchocardiographyStroke volumeAnesthesiologyRD78.3-87.3Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENAin Shams Journal of Anesthesiology, Vol 13, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Inferior vena cava collapsibility index IVC max IVC min Ultrasonography Echocardiography Stroke volume Anesthesiology RD78.3-87.3 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Inferior vena cava collapsibility index IVC max IVC min Ultrasonography Echocardiography Stroke volume Anesthesiology RD78.3-87.3 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Ahmed Ibrahim Nagi Azza Mohamed Shafik Amr Mohamed Abdel Fatah Wessam Zaher Selima Amira Fathy Hefny Inferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure
description	Abstract Background Assessing fluid responsiveness is the key to successful resuscitation of critically-ill sepsis patients. The use of IVC variation is favored among the dynamic methods of fluid responsiveness assessment in the ICU because it is non-invasive and inexpensive; moreover, it does not demand a high level of training. The aim of this study is to determine the value of the IVC respiratory variability for predicting fluid responsiveness in spontaneously breathing sepsis patients with acute circulatory failure. Results In this prospective observational study, fifty-eight spontaneously breathing sepsis patients admitted in the ICU were enrolled after the approval of the departmental Research Ethical Committee, and the informed written consent had been taken from the patients. Ultrasonographic and echocardiographic parameters were measured “IVC parameters and stroke volume (SV)” with calculation of the inferior vena cava collapsibility index (IVCCI) and cardiac output. These values were obtained before (baseline) and after volume expansion with a fluid bolus. The study showed that twenty-nine patients (50%) were considered to be responders, with an increase in CO by 10% or more after fluid challenge. There was a significant difference between responders and non-responders in baseline IVCCI (p value < 0.001). There were no significant differences between responders and non-responders in terms of demographic and baseline clinical characteristics. Also, there was statistically significantly larger maximum (IVC max) and minimum (IVC min) inferior vena cava diameters before volume expansion in non-responders than in responders with p value 0.037 and 0.001 respectively. The suggested cut off value regarding baseline IVCCI to predict response to fluid infusion is 0.32 with a high chance of response above this figure (a sensitivity of 72.41% and a specificity of 82.76%). Conclusions Inferior vena cava collapsibility index assessment can be a sensitive and a good predictor of fluid responsiveness, being based on a safe and a non-invasive technique compared to other methods such as central venous pressure (CVP) measurement and pulmonary artery catheter insertion.
format	article
author	Ahmed Ibrahim Nagi Azza Mohamed Shafik Amr Mohamed Abdel Fatah Wessam Zaher Selima Amira Fathy Hefny
author_facet	Ahmed Ibrahim Nagi Azza Mohamed Shafik Amr Mohamed Abdel Fatah Wessam Zaher Selima Amira Fathy Hefny
author_sort	Ahmed Ibrahim Nagi
title	Inferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure
title_short	Inferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure
title_full	Inferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure
title_fullStr	Inferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure
title_full_unstemmed	Inferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure
title_sort	inferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/ade9bed7dcc94c63ba45e83cc1153f3a
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Inferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure

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