Inferior Vena Cava Collapsibility Index in Correlation with Central Venous Pressure and Cardiac Output in Assessment of Fluid Status in Pre-Renal Acute Kidney Injury in Critically Ill Patients

Mohamed, Mohamed Abdelhafez; El Mahallawy, Mohamed Ahmed; Hemida, Mahmoud Hadad; Mohamed,, Mohamed Aboelnaga

doi:https://doi.org/10.21608/aimj.2025.446648

Inferior Vena Cava Collapsibility Index in Correlation with Central Venous Pressure and Cardiac Output in Assessment of Fluid Status in Pre-Renal Acute Kidney Injury in Critically Ill Patients

Document Type : Original Article

Authors

¹ MSc., Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

² Assistant Professor of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

³ Professor of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

⁴ Assistant Professor of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

https://doi.org/10.21608/aimj.2025.446648

Abstract

Background: Patients with acute renal diseases, especially those with complicated comorbidities needing hospitalization or intensive care, require volume management based on an accurate evaluation of relative intravascular volume.
Aim of the work: To measure the value of inferior vena cava(IVC) measurements measured by point-of-care ultrasound(POCUS), central venous pressure(CVP) measured via central venous catheter and cardiac output(CO) in assessment of intravascular volume status of patients, evaluating the correlation between IVC-collapsibility index(IVC-CI) in correlation to CVP and CO in assessment of volume status of critically ill patients, complementary predictors of the clinical response.
Methods: Fifty male and female patients (all over the age of 18) participated in this prospective cross-sectional observational study. After obtaining consent from patients or their first-degree relatives in the case of unconscious patients, an intrathoracic central venous catheter was placed and inserted to terminate in the superior vena cava. Fluid responders(n=30) and non-fluid responders(n=20) were the two groups of patients.
Results: For the group of non-fluid responders, a positive correlation(P<0.05) was found between CI and CO. For the non-fluid responder group, there was a negative correlation between CI and urine output (UOP) both immediately and after 1 hour, as well as IVC min and max(P<0.05). Within the group of fluid responders, a positive connection was found between CVP and CO, UOP at both the immediate and 1-hour intervals, and IVC minimum and maximum (P<0.05).
Conclusions: In prerenal acute kidney injury in critically ill patients. CI can significantly predict mortality and non-fluid responses, while CVP can significantly predict non-fluid responses.

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