Measurement of Inferior Vena Cava Collapsibility Index
and Its Correlation to Central Venous Pressure in Adult
Critically Ill Patients A Prospective Observational Study
Volume 3 - Issue 4
Azza Ahmed Ameen Hafez*
- Consultant of Anesthesia & Intensive Care, Zagazig University Hospital, Egypt
Received: August 29, 2020; Published:September 10, 2020
Corresponding author: Azza Ahmed Ameen Hafez, MD, Consultant of Anesthesia & Intensive Care, Zagazig University Hospital,
Zagazig, Egypt
DOI: 10.32474/GJAPM.2020.03.000170
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Abstract
Fluid therapy is an essential component part management of critically ill patients. Proper estimation of the amount of needed
fluids is of great importance due to the well-established adverse effects of marked negative and positive fluids balance. Central
venous pressure has been widely used by ICU physicians for volume status assessment. Several methods have been postulated
for volume status assessment, among which is the inferior vena cava collapsibility index. As the inferior vena cava is a thin-walled
capacitance vessel that adjusts to the body’s volume status by changing its diameter depending on the total body fluid volume. Giving
the fact that bedside ultrasonographic measurement of inferior vena cava diameters is an available, non-invasive, reproducible, and
quiet easy-to-learn technique, it can provide a safe and quiet reliable replacement of central venous pressure measurement for
assessment of volume status assessment.
The aim of this study: was to find statistical correlation between central venous pressure and caval index, as a step
towards validating the above-mentioned replacement. 86 critically ill patients from ICU population were enrolled. Simultaneous
measurements of central venous pressure and inferior vena cava collapsibility index were observed and recorded on four sessions.
Patients were also grouped based on their mode of ventilation and central venous pressure values to compare the strength of
correlation between various populations.
The results: showed that Inferior vena cava collapsibility index has significant inverse correlation with CVP value (r= -85, p
value ˂0.001 at 95% CI) and it better correlated with mean arterial blood pressure and lactate clearance as compared to central
venous pressure. However, it correlated better with CVP in spontaneously breathing patients (r= -0.86, p value ˂0.001) than in
mechanically ventilated patients (r= -0.84, p value ˂0.001). Inferior vena cava collapsibility index has shown to correlate better with
CVP value in lower values (˂ 10 cmH2O) (r= -0.8, p value ˂0.001) than in higher values (≥10 cmH2O) (r= -0.6, p value ˂0.001). In
addition, an inferior vena caval collapsibility index cut-off value of 29% was shown to discriminate between CVP values ˂10 cmH2O
and values ≥10 cmH2O with high Sensitivity (88.6%) and specificity (80.4%).
In conclusion: inferior vena cava collapsibility index has a strong inverse relationship with central venous pressure which
is more pronounced at low central venous pressure values. Point-of-care ultrasono graphically measured inferior vena cava
collapsibility index is very likely to be a good alternative to central venous pressure measurement with a high degree of precision
and reproducibility. However, Wide scale studies are needed to validate it is use in different patient populations.
Abstract|
Introduction|
Aim of the Work|
Subjects and Methods|
Statistically Analyzed|
Results|
Receiver Operator Characteristics (ROC) Curve|
Discussion|
Conclusion|
References|