The effect of ultrasonographic measurement of vena cava inferior diameter on the prediction of post‐spinal hypotension in geriatric patients undergoing spinal anaesthesia

Aslan, Yusuf; Arslan, Gülten; Saraçoğlu, Kemal Tolga; Çevik, Banu

doi:10.1111/ijcp.14622

Cited by 5 publications

(12 citation statements)

References 11 publications

(10 reference statements)

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“…Multivariable logistic regression analysis was performed to detect the association between IVCCI and hypotension following spinal anesthesia. Variables including demographic characteristics, ASA physical status, baseline MBP, dIVCmax, and IVCCI potentially associated with hypotension following spinal anesthesia or those that had a p-value < 0.10 in the univariate analyses were included in the multivariate logistic regression analyses (1,6,(20)(21)(22). Multicollinearity diagnostic tests were carried out by variance inflation factor (VIF).…”

Section: Discussionmentioning

confidence: 99%

Inferior Vena Cava Collapsibility Index Can Predict Hypotension and Guide Fluid Management After Spinal Anesthesia

Zhou

et al. 2022

Front. Surg.

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PurposeWe hypothesized that inferior vena cava collapsibility index (IVCCI)-guided fluid management would reduce the incidence of postspinal anesthesia hypotension in patients undergoing non-cardiovascular, non-obstetric surgery.MethodsA receiver operating characteristic (ROC) curve was used to determine the diagnostic value of IVCCI for predicting hypotension after induction of spinal anesthesia and calculate the cut-off value. Based on the cut-off variation value, the following prospective randomized controlled trial aimed to compare the incidence of postspinal anesthesia hypotension between the IVCCI-guided fluid administration group and the standard fluid administration group. Secondary outcomes included the rate of vasoactive drug administration, the amount of fluid administered, and the incidence of nausea and vomiting.ResultsROC curve analysis revealed that IVCCI had a sensitivity of 83.9%, a specificity of 76.3%, and a positive predictive value of 84% for predicting postspinal anesthesia hypotension at a cut-off point of >42%. The area under the curve (AUC) was 0.834 (95% confidence interval: 0.740–0.904). According to the cut-off variation value of 42%, the IVCCI-guided group exhibited a lower incidence of hypotension than the standard group [9 (15.3%) vs. 20 (31.7%), P = 0.032]. Total fluid administered was lower in the IVCCI-guided group than in the standard group [330 (0–560) mL vs. 345 (285–670) mL, P = 0.030].ConclusionsPrespinal ultrasound scanning of the IVCCI provides a reliable predictor of hypotension following spinal anesthesia at a cut-off point of >42%. IVCCI-guided fluid management before spinal anesthesia can reduce the incidence of hypotension following spinal anesthesia.

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Section: Discussionmentioning

confidence: 99%

Inferior Vena Cava Collapsibility Index Can Predict Hypotension and Guide Fluid Management After Spinal Anesthesia

Zhou

et al. 2022

Front. Surg.

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“…The role of IVCUS to predict PSH was assessed in 15 studies [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Among them 4 prospective observational studies evaluated PSH in a parturient undergoing caesarean section [11][12][13][14].…”

Section: Patient Population and Type Of Surgerymentioning

confidence: 99%

“…In studies among non-parturients, 4 studies were randomized controlled trials [15][16][17]25] and the rest were observational studies [18][19][20][21][22][23][24]. These studies were conducted in procedures such as hernia and hydrocele [16], orthopaedic lower limb surgery [15,[20][21][22], and various other operations performed under spinal anaesthesia.…”

Section: Patient Population and Type Of Surgerymentioning

confidence: 99%

“…These studies included adult patients between 18 and 75 years old [19]. Two studies recruited only elderly patients [22,23]. Among the studies done in non-parturient patients, 8 studies excluded American Society of Anaesthesiology (ASA) class ≥ III [15][16][17][18][19][20][21]24], whereas 1 study each included ASA class I-III [25], ASA class II-III [22]and ASA class I-IV [23] Six observational studies evaluated the role of preoperative IVCUS for PIH in non-pregnant patients undergoing elective surgery under GA [26][27][28][29][30][31].…”

Section: Patient Population and Type Of Surgerymentioning

confidence: 99%

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The use of preoperative inferior vena cava ultrasound to predict anaesthesia-induced hypotension: a systematic review

Chowdhury¹,

Datta²,

Maitra³

et al. 2023

ait

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Intraoperative hypotension after induction or initiation of anaesthesia is a common complication in clinical practice. It has been associated with poor patient outcomes including increased perioperative morbidity and even mortality [1]. Some special patient populations, such as the elderly and pregnant women undergoing caesarean section, are particularly prone to developing significant anaesthesia-induced hypotension (AIH) due to their unique physiological characteristics. Hypotension after induction of general anaesthesia (PIH, postinduction hypotension) or administration of spinal anaesthesia (PSH, post-spinal hypotension) is common and profound in patients with intravas-

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“…Point of care transthoracic echocardiography (TTE) is featured prominently in clinical practice to evaluate cardiovascular hemodynamics [9][10][11]. In fact, there are numerous echocardiographic indices, as well recommendations regarding the optimal thresholds of echocardiographic measurements in various clinical scenarios and contexts [9][10][11][12]. Inferior vena cava (IVC) ultrasound measurements have shown high specificity in the diagnosis of acute dyspnea of cardiac origin [9].…”

Section: Introductionmentioning

confidence: 99%

Point of care transthoracic echocardiography for the prediction of post – spinal anesthesia hypotension in elderly patients with cardiac diseases and left ventricular dysfunction

Moschovaki

Saranteas

Spiliotaki

et al. 2023

J Clin Monit Comput

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In elderly patients with cardiac diseases, changes in cardiovascular physiology diminish cardiovascular reserve and predispose to hemodynamic instability after spinal anesthesia; hence, such patients could be at risk of postoperative complications. Additionally, transthoracic echocardiography (TTE) is used in clinical practice to evaluate cardiovascular hemodynamics. Therefore, we hypothesized that echocardiographic measurements could display significant diagnostic power in the prediction of post - spinal anesthesia hypotension in elderly patients with cardiac diseases and reduced left ventricular ejection fraction (LV-EF). Therefore, sixty-one elderly orthopedic-trauma patients were recruited. Prior to spinal anesthesia a TTE examination was performed. The LV-EF, the stroke volume index (SVI), the peripheral vascular resistance (PVR), the LV filling pressures (E/Em ratio), the right ventricular function [tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TASV) and fractional area change (FAC)], as well as inferior vena cava (IVC) measurements, such as IVCCI (collapsibility index of the IVC) and dIVCmax (maximum diameter of IVC)-to-IVCCI ratio were assessed. Twenty-six out of sixty-one patients manifested hypotension. Preoperative dIVCmax-to-IVCCI ratio demonstrated the greatest performance amongst echocardiographic indices in predicting post - spinal anesthesia hypotension. The dIVCmax-to-IVCCI ratio < 48 had significantly higher diagnostic power than IVCCI > 0.28, FAC > 42, E/Em ratio < 9 and SVI < 32 (receiver operator characteristic curve analysis). The gray zone for the dIVCmax-to-IVCCI ratio (40–49) showed the lowest number of inconclusive measurements among echocardiographic variables. The preoperative dIVCmax-to-IVCCI ratio could be a reliable echocardiographic index to predict post - spinal anesthesia hypotension in elderly patients with left ventricular dysfunction.

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The effect of ultrasonographic measurement of vena cava inferior diameter on the prediction of post‐spinal hypotension in geriatric patients undergoing spinal anaesthesia

Cited by 5 publications

References 11 publications

Inferior Vena Cava Collapsibility Index Can Predict Hypotension and Guide Fluid Management After Spinal Anesthesia

Inferior Vena Cava Collapsibility Index Can Predict Hypotension and Guide Fluid Management After Spinal Anesthesia

The use of preoperative inferior vena cava ultrasound to predict anaesthesia-induced hypotension: a systematic review

Point of care transthoracic echocardiography for the prediction of post – spinal anesthesia hypotension in elderly patients with cardiac diseases and left ventricular dysfunction

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