Accuracy of Ultrasonographic Measurements of Inferior Vena Cava to Determine Fluid Responsiveness: A Systematic Review and Meta-Analysis

Orso, Daniele; Paoli, Irene; Piani, Tommaso; Cilenti, Francesco L.; Cristiani, Lorenzo; Guglielmo, Nicola

doi:10.1177/0885066617752308

Cited by 151 publications

(139 citation statements)

References 50 publications

(61 reference statements)

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“…[47][48][49][50] The two most recent conclude simply that ''respiratory variation in IVC diameter has limited ability to predict FR'' 46 and that ''ultrasound evaluation of the diameter of the IVC and its respiratory variations does not seem to be a reliable method to predict FR''. 50 It is likely that IVC analysis will eventually be seen as a modern day central venous pressure; rapidly and enthusiastically adopted not because it was accurate but because it was easy, and because we were desperate for a solution to an important problem. We are still desperate for a practical solution to this same FR problem, but it seems clear that IVC analysis will not be helpful for a large majority of patients and should therefore be abandoned in most situations.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound assessment of the inferior vena cava for fluid responsiveness: easy, fun, but unlikely to be helpful

Millington

2019

Can J Anesth/J Can Anesth

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Section: Discussionmentioning

confidence: 99%

Ultrasound assessment of the inferior vena cava for fluid responsiveness: easy, fun, but unlikely to be helpful

Millington

2019

Can J Anesth/J Can Anesth

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“…In this meta-analysis, the fluid volume had a significant diversity between each study, but whether a patient's exposure to a positive or negative fluid balance is detrimental remains controversial. Therefore, when a patient needs fluid resuscitation, we should not only consider the fluid type but also consider the fluid responsiveness [38].…”

Section: Discussionmentioning

confidence: 99%

Balanced crystalloids versus normal saline for fluid resuscitation in critically ill patients: A systematic review and meta-analysis with trial sequential analysis

Liu

Wang

et al. 2019

The American Journal of Emergency Medicine

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a b s t r a c tIntroduction: Fluid resuscitation is a fundamental component of the management of critically ill patients, but whether choice of crystalloid affects patient outcomes remains controversial. Therefore, we performed this meta-analysis to compare the efficacy and safety of balanced crystalloids with normal saline. Methods: We searched the MEDLINE, Cochrane Central and EMBASE up to October 2018 to identify randomized controlled trials (RCTs) that compared balanced crystalloids versus normal saline in critically ill patients. The primary outcome was mortality. The secondary results were the incidence of acute kidney injury (AKI) and risk of receiving renal replacement therapy (RRT). Two authors independently screened articles based on the inclusion and exclusion criteria. The meta-analysis was conducted using Revman 5.3, trial sequential analysis (TSA) 0.9 and STATA 12.0. Results: Nine RCTs were identified. The pooled analyses showed that there were no significant differences in mortality (relative risk (RR) = 0.93, 95% confidence interval (CI) = 0.86, 1.01, P = 0.08), incidence of AKI (RR 0.94, 95% CI 0.88, 1.00, P = 0.06) or RRT use rate (RR 0.94, 95% CI 0.69, 1.27, P = 0.67) between balanced crystalloids and normal saline groups. However, TSA did not provide conclusive evidence. Conclusions: Among critically ill patients receiving crystalloid fluid therapy, use of a balanced crystalloid compared with normal saline did not reduce the mortality, risk of severe AKI or RRT use rate. Further large randomized clinical trials are needed to confirm or refute this finding. Trial registration: A protocol of this meta-analysis has been registered on PROSPERO (registration number: CRD42018094857).

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“…14,15 However, other meta-analyses on DCIIVC concluded that it is not a reliable method to predict uid responsiveness. 16,17 Hence, the effectiveness of DCIIVC to predict VS or uid responsiveness has not yet reached a conclusion.…”

Section: Discussionmentioning

confidence: 99%

Diameter and collapse index of inferior vena cava as a clinical indicator of resuscitation for critically ill hypotensive patients

Mun¹

2020

Preprint

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Purpose The role of diameter and collapse index of inferior vena cava (DCIIVC) in reflecting intravascular volume status and fluid responsiveness remains unclear. We aimed to evaluate the effectiveness of DCIIVC as a clinical indicator for fluid resuscitation (FR) in critically ill hypotensive patients.Methods This retrospective study enrolled hypotensive patients admitted to the surgical intensive care unit (SICU) between May 2018 and April 2019. Between May and October 2018, fluid therapy was conducted by a physician’s decision (non-DCIIVC group, 32 patients). Between November 2018 and April 2019, DCIIVC was used as a guide (DCIIVC group, 30 patients). Clinical outcomes of the two periods were compared.Results Total amount of fluid intake (TAFI) of non-DCIIVC and DCIIVC group in 24 h was 4,130 and 3,560, respectively (p < 0.05). TAFI in 48 h was 8,420 and 6,910, respectively (p < 0.01). Lactate levels at admission, 24 and 48 h after admission were 4.1 vs 3.8, 3.2 vs 3.1, and 1.9 vs 2.1 mmol/L, respectively. Mean duration of mechanical ventilation, ICU stay, and hospital stay were 4.1 vs 4.5, 7.2 vs 6.3, and 18.1 vs 17.2, respectively. Overall mortality was 16.7% vs 13.3%. There was no significant difference in any other characteristic except TAFI.Conclusion DCIIVC can be used as a tool for indicating FR in critically ill hypotensive patients. This can help physicians infuse fluid restrictively, without adverse outcomes.

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Accuracy of Ultrasonographic Measurements of Inferior Vena Cava to Determine Fluid Responsiveness: A Systematic Review and Meta-Analysis

Abstract: An extreme heterogeneity of included studies was highlighted. Ultrasound evaluation of the diameter of the IVC and its respiratory variations does not seem to be a reliable method to predict fluid responsiveness.

Cited by 151 publications

References 50 publications

Ultrasound assessment of the inferior vena cava for fluid responsiveness: easy, fun, but unlikely to be helpful

Ultrasound assessment of the inferior vena cava for fluid responsiveness: easy, fun, but unlikely to be helpful

Balanced crystalloids versus normal saline for fluid resuscitation in critically ill patients: A systematic review and meta-analysis with trial sequential analysis

Diameter and collapse index of inferior vena cava as a clinical indicator of resuscitation for critically ill hypotensive patients

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