Does caval aorta index correlate with central venous pressure in intravascular volume assessment in patients undergoing endoscopic transuretheral resection of prostate?

Abstract

Background and Objective:Ultrasonography has been suggested as a useful noninvasive tool for intravascular volume assessment in critically ill-patients. Fluid absorption is an inevitable complication of transurethral resection of the prostate (TURP). However, there are few data comparing the caval aortic index with central venous pressure (CVP) measurement for intravascular volume assessment in patients undergoing TURP.Materials and Methods:This is a prospective observer blinded study carried out on 50 patients who underwent elective TURP. The primary outcome measure of our study was the correlation of the caval aorta (Ao) index with CVP, and the secondary outcome measures were the sensitivity and specificity of the caval Ao index.Results:There was a positive correlation of inferior vena cava/Ao (IVC/Ao) index to CVP (R = 0.9 and significant P = 0.001*). The sensitivity and specificity of the IVC/Ao index were measured to predict the CVP. A CVP ≤7 cm H2O correlated with IVC/Ao index 0.8 ± 0.3 mean ± standard deviation (SD) (sensitivity 0.93, specificity 0.66), a CVP of 8-12 cm H2O correlated with IVC/Ao index 1.5 ± 0.2 mean ± SD (sensitivity 0.96, specificity 0.42), and a CVP >12 cm H2O correlated with IVC/Ao index 1.8 ± 0.07 mean ± SD (sensitivity 0.93, specificity 0.58).Conclusion:Sonographic caval Ao index is useful for the evaluation of preoperative and intraoperative volume status, especially in major surgeries with marked fluid shift or blood loss and had the advantage of being noninvasive, safe, quick, and easy technique with no complications.

Initial inferior vena cava and aorta diameter parameters measured by ultrasonography or computed tomography does not correlate with vital signs, hemorrhage or shock markers in trauma patients

“…Several other studies showed a significant relationship between dIVC/dAorta index and CVP; unfortunately, the value of CVP as a good surrogate marker of fluid status was recently questioned. [25,26] In more recent studies, dIVC/dAorta index was shown to have a low predictive value and more susceptible to patient characteristics than IVC. [19,[27][28][29] In this study, we classified patients according to their SI at admission as low and high risk, and we found the differences in dIVCe and dIVC-CT to be statistically significant, and dAorta-US and CT at significance margin.…”

Application of Lung Ultrasound in Monitoring Fluid Overload During Transurethral Resection of the Prostate: A Feasibility Study

“…There are many monitoring methods for uid absorption during TURP, such as adding ethanol to irrigation uid [22], monitoring hemodynamics [23], and weighing [24], but almost all of them are currently not satisfactory. The pulse index continuous cardiac output (PICCO) technique is the gold standard for bedside quantitative measurements of EVLW.…”

Use of bedside ultrasound to assess fluid status: a literature review

“…15 Additionally, the IVC/Ao index has been found to be useful for the evaluation of preoperative and intraoperative volume status, especially in a major surgery with marked fluid shift or blood loss. 16 Other target groups for the application of ultrasonography in the assessment of body fluid status are patients with cardiovascular diseases, for example, those with exacerbation of congestive heart failure (HF), kidney diseases (such as acute kidney injury and exacerbation of chronic kidney disease [CKD]), as well as patients on dialysis. In these populations, the assessment of the initial body fluid status is essential, but more importantly, these patients should be carefully monitored during fluid therapy or fluid removal.…”