Correlation of Inferior Vena Cava Distensibility Index and Pulse Pressure Variation in Prediction of Fluid Responsiveness in Mechanically Ventilated Hypotensive Patients

Authors

1 Anaesthesia, Intensive Care and Pain Management Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background; Shocked patients require careful monitoring of intravascular volume and treatment with intravenous fluids. In the intensive care unit (ICU), patients with acute circulatory insufficiency typically benefit from fluid resuscitation. Objectives; to compare the sensitivity of the pulse pressure variation (PPV) and the distensibility index of the Inferior Vena Cava (dIVC) for predicting fluid responsiveness in very ill patients who suffered shock. Patients and Methods: This was an interventional, cross-sectional study, that evaluated mechanically ventilated ICU patients, presented with clinical signs of shock. The study was carried out at al Azhar university hospitals and conducted on 100 individuals. Results; The dIVC and the PPV values fluctuated between 0.17- 1.0 and 0.13 – 0.42 respectively. Using a cutoff of > 19.7%, dIVC was 65.6% sensitive, 72.4% specific, had an AUC of 0.734, and was statistically highly significant (P< 0.001). PPV's sensitivity was 45.1%, specificity was 68.5%, AUC was 0.642, and significant (p = 0.018) at a threshold value of > 14%. Conclusion: It is important to use caution when employing either PPV or dIVC as predictors of fluid response in shocked patients. Diagnostic performance was higher with dIVC than with PPV.

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