A New Formula for Non-invasive Assessment of Intravascular Fluid Status with Inferior Vena Cava Diameters and Collapsibility Index: A Pilot Study

Karacabey, Sinan; Sanri, Erkman; Güneysel, Özlem

doi:10.12669/pjms.324.10290

Cited by 13 publications

(19 citation statements)

References 26 publications

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“…IVCCI is a simple predictor of volume responsiveness both in mechanically ventilated and spontaneously breathing patients. [12131415] An observational study reported that IVCCI >42% has 97% specificity and 90% positive predictive value for fluid responsiveness spontaneously breathing adult patients. [12] Zhang et al .…”

Section: Discussionmentioning

confidence: 99%

Role of IVC collapsibility index to predict post spinal hypotension in pregnant women undergoing caesarean section. An observational trial

et al. 2019

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Background:Postspinal anesthesia hypotension (PSH) in pregnant women is common and may lead to poor maternal and fetal outcome. Fluid loading in pregnant women before spinal anesthesia to prevent hypotension is of limited ability. We hypothesized that those women who are hypovolemic before spinal anesthesia may be at risk of PSH and inferior vena cava collapsibility index (IVCCI) will be able to identify hypovolemic parturients.Methods:In this prospective observational study, n = 45 women undergoing elective lower segment cesarean section with singleton pregnancy were recruited and IVCCI in left lateral tilt (with wedge) and supine position (without wedge) were noted by M-mode ultrasound (USG) before spinal anesthesia. After spinal anesthesia, changes in blood pressure were noted till 15 min after spinal anesthesia.Results:USG measurements were obtained in 40 patients and 23 of 40 patients (57.5%) had at least one episode of hypotension. Area under the ROC curve of IVCCI with wedge to predict PSH was 0.46 (95% CI 0.27, 0.64) and best cut-of value was 25.64 with a sensitivity and specificity of 60.9% and 35.5%, respectively. Area under the ROC curve of IVCCI without wedge to predict PSH was 0.38 (95% CI 0.19, 0.56) and best cut-of value was 20.4 with a sensitivity and specificity of 69.6% and 23.5%, respectively.Conclusion:We conclude that IVCCI is not a predictor of PSH in pregnant women undergoing elective cesarean section.

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Section: Discussionmentioning

confidence: 99%

Role of IVC collapsibility index to predict post spinal hypotension in pregnant women undergoing caesarean section. An observational trial

et al. 2019

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“…In human medicine, a similar problem exists in determining intravascular volume status in critical patients . Recent studies have identified numerous deficiencies with the current methods used to estimate fluid status, including heart rate, blood pressure, physical examination findings, and laboratory findings .…”

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confidence: 99%

Influence of the Respiratory Cycle on Caudal Vena Cava Diameter Measured by Sonography in Healthy Foals: A Pilot Study

Tuplin

Romero

Boysen

2017

Veterinary Internal Medicne

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BackgroundIntravascular volume assessment in foals is challenging. In humans, intravascular volume status is estimated by the caudal vena cava (CVC) collapsibility index (CVC‐CI) defined as (CVC diameter at maximum expiration [CVC max] – CVC diameter at minimal inspiration [CVC min])/CVC max × 100%.Hypothesis/ObjectivesTo determine whether the CVC could be sonographically measured in healthy foals, determine differences in CVC max and CVC min, and calculate inter‐ and intrarater variability between 2 examiners. We hypothesized that the CVC could be measured sonographically at the subxiphoid view and that there would be a difference between CVC max and CVC min values.AnimalsSixty privately owned foals <1‐month‐old.MethodsProspective study. A longitudinal subxiphoid sonographic window in standing foals was used. The CVC max and CVC min were analyzed by a linear mixed effect model. Inter‐rater agreement and intrarater variability were expressed by Bland‐Altman and intraclass correlation coefficients, respectively.ResultsMeasurements were attained from 58 of 60 foals with mean age of 15 ± 7.9 days and mean weight of 75.7 ± 17.7 kg. The CVC max was significantly different from CVC min (D = 0.515, SE = 0.031, P < 0.001). Inter‐rater agreement of the CVC‐CI differed by an average of −0.9% (95% limits of agreement, −12.5 to +10.7%). Intrarater variability of CVC max was 0.540 and 0.545, of CVC min was 0.550 and 0.594, and of CVC‐CI was 0.894 and 0.853 for observers 1 and 2, respectively.Conclusions and Clinical ImportanceThese results indicate it is possible to reliably measure the CVC sonographically in healthy foals, and the CVC‐CI may prove useful in assessing the intravascular volume status in hypovolemic foals.

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“…[1,21] Much research has focused on the elasticity of large veins, such as the inferior vena cava and the internal jugular vein, to calculate standardized parameters for the determination of fluid responsiveness, including the collapsibility index. [2,[22][23][24] These parameters are related to more traditional predictors of fluid responsiveness like central venous pressure. Emerging studies, however, demonstrate that large arteries, such as the common carotid artery, are also dynamically compliant, and can predict fl uid responsiveness.…”

Section: Discussionmentioning

confidence: 99%

“…A study in 2016 by Karacabey et al [2] revealed that measures of IVC collapsibility were inversely correlated with CVP measurements in intubated patients. If the diameter of the IVC is less than 2.1 cm and decreases by more than half during inhalation, then the right atrial pressure sits within the normal range of 0-5 mmHg.…”

Section: Understanding Measurement Of Ivc (Diameter Collapsibility mentioning

confidence: 99%

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The utility of point-of-care ultrasound in the assessment of volume status in acute and critically ill patients

Pourmand¹,

Pyle²,

Yamane³

et al. 2019

World Journal of Emergency Medicine

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BACKGROUND: Volume resuscitation has only been demonstrated to be effective in approximately fifty percent of patients. The remaining patients do not respond to volume resuscitation and may even develop adverse outcomes (such as acute pulmonary edema necessitating endotracheal intubation). We believe that point-of-care ultrasound is an excellent modality by which to adequately predict which patients may benefi t from volume resuscitation. DATA RESOURCES: We performed a search using PubMed, Scopus, and MEDLINE. The following search terms were used: fluid responsiveness, ultrasound, non-invasive, hemodynamic, fluid challenge, and passive leg raise. Preference was given to clinical trials and review articles that were most relevant to the topic of assessing a patient's cardiovascular ability to respond to intravenous fl uid administration using ultrasound. RESULTS: Point-of-care ultrasound can be easily employed to measure the diameter and collapsibility of various large vessels including the inferior vena cava, common carotid artery, subclavian vein, internal jugular vein, and femoral vein. Such parameters are closely related to dynamic measures of fluid responsiveness and can be used by providers to help guide fluid resuscitation in critically ill patients. CONCLUSION: Ultrasound in combination with passive leg raise is a non-invasive, costand time-effective modality that can be employed to assess volume status and response to fluid resuscitation. Traditionally sonographic studies have focused on the evaluation of large veins such as the inferior vena cava, and internal jugular vein. A number of recently published studies also demonstrate the usefulness of evaluating large arteries to predict volume status.

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A New Formula for Non-invasive Assessment of Intravascular Fluid Status with Inferior Vena Cava Diameters and Collapsibility Index: A Pilot Study

Cited by 13 publications

References 26 publications

Role of IVC collapsibility index to predict post spinal hypotension in pregnant women undergoing caesarean section. An observational trial

Role of IVC collapsibility index to predict post spinal hypotension in pregnant women undergoing caesarean section. An observational trial

Influence of the Respiratory Cycle on Caudal Vena Cava Diameter Measured by Sonography in Healthy Foals: A Pilot Study

The utility of point-of-care ultrasound in the assessment of volume status in acute and critically ill patients

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