Role of Inferior Vena Cava Assessment in Management of Acute Kidney Injury Patients in Medical Intensive Care Unit

Seliem, Ahmad Elsayed Mohammed; Abo-Alhassan, Ahmad Mohammed Ahmad; Metwaley, Mostafa Mohammed Elsayed; Elnady, Khaled Mohammed Yehia

doi:10.21608/aimj.2025.446442

Role of Inferior Vena Cava Assessment in Management of Acute Kidney Injury Patients in Medical Intensive Care Unit

Document Type : Original Article

Authors

¹ Internal Medicine, Faculty of Medicine for boys, Al-Azhar University, Cairo, Egypt

² Cardiology, Military Medical Academy, Cairo, Egypt

10.21608/aimj.2025.446442

Abstract

Background: Patients in critical care often have acute kidney injury (AKI), a serious condition that frequently necessitates careful fluid management to avoid additional complications. Fluid therapy in the medical intensive care unit (MICU) can be guided by the inferior vena cava (IVC) collapsibility index, which can be assessed using bedside echocardiography and is a non-invasive substitute for central venous pressure (CVP).
Aim of the work: Compared to CVP measurements, this study sought to determine if IVC assessment was more useful in fluid management for patients with AKI.
Patients and Methods: The MICU at Al-Hussein University Hospital in Cairo, Egypt, was the site of a prospective observational study. We randomly divided forty individuals with acute kidney injury into two groups: Group 2 depended on CVP values for fluid therapy, whereas Group 1 used IVC collapsibility indices as guidance. There was a 48-hour data collection period for baseline and follow-up hemodynamic parameters, urine output, and serum creatinine.
Results: Both groups demonstrated significant improvements in serum creatinine levels and urine output after 48 hours. Group 1 showed superior dynamic changes in IVC collapsibility indices and a better correlation with fluid responsiveness. Overall renal results, however, did not differ significantly between the two groups.
Conclusion: IVC collapsibility indices provide a viable, non-invasive alternative to CVP for fluid management in critically ill AKI patients. However, further studies with larger sample sizes are recommended to validate these findings.

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