Correlation of Inferior Vena Cava diameter and IVC Collapsibility Index with central venous pressure (CVP) in critically ill surgical patients
Abstract
IntroductionCentral Venous Pressure is a valuable parameter in the management of critically ill surgical patients in the ICU. Non-invasive methods to extrapolate the volume status of the patient can aid clinicians in expediting proper treatment. The objective of this study is to find a correlation between Inferior Vena cava (IVC) diameter and collapsibility index (CI) with Central venous pressure (CVP) in critically ill surgical patients.
Methods
This cross-sectional study included 60 critically ill patients from September 2020 – 31st February 2021. We recorded the patient's age, sex, heart rate, blood pressure, CVP, volume status, IVC minimum, and maximum diameter. After taking consent and explaining the procedure to the patient, the maximum IVC anteroposterior diameter was noted at the end of inspiration and end of expiration in centimeters. IVC collapsibility index was calculated using the formula ([IVCdmax-IVCdmin]/IVCdmax*100%). Following this, the CVP of the patient was measured.
Results
Among the patients evaluated, 32 were females. The mean age of the participants was 44.90 ± 15.76 years. The mean central venous pressure maintained was 11.10 ± 2.11cm H2O with an inferior vena cava collapsibility index of 29.69 ± 8.75. There was a negative correlation between CVP and IVC collapsibility index (%), which was statistically significant (r = -0.701, n = 60, p < 0.01). A strong positive correlation between CVP and maximum IVC diameter (r = 0.712, n = 60, p < 0.01) and minimum IVC diameter (r = 0.796, n = 60, p < 0.01) was found.
Conclusion
Inferior Vena Cava diameter and IVC Collapsibility Index can be used as a reliable substitute to central venous pressure to determine the patient's volume status.
References
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3.Roger C, Muller L, Riou B, Molinari N, Louart B, Kerbrat H, et al. Comparison of different techniques of central venous pressure measurement in mechanically ventilated critically ill patients. Br J Anaesth. 2017;118(2):223–31.
4.Ilyas A, Ishtiaq W, Assad S, Ghazanfar H, Mansoor S, Haris M, et al. Correlation of IVC Diameter and Collapsibility Index With Central Venous Pressure in the Assessment of Intravascular Volume in Critically Ill Patients. Cureus. 2017;9(2).
5.Natori H, Tamaki S, Kira S. Ultrasonographic evaluation of ventilatory effect on inferior vena caval configuration. Am Rev Respir Dis. 1979;120(2):421–7.
6.Nagdev AD, Merchant RC, Tirado-Gonzalez A, Sisson CA, Murphy MC. Emergency Department Bedside Ultrasonographic Measurement of the Caval Index for Noninvasive Determination of Low Central Venous Pressure. Ann Emerg Med. 2010;55(3):290–5.
7.Fields JM, Lee PA, Jenq KY, Mark DG, Panebianco NL, Dean AJ. The interrater reliability of inferior vena cava ultrasound by bedside clinician sonographers in emergency department patients. Acad Emerg Med. 2011;18(1):98–101.
8.Vincent JL, Jones G, David S, Olariu E, Cadwell KK. Frequency and mortality of septic shock in Europe and North America: A systematic review and meta-analysis. Crit Care 2019;23(1):34-45.
9.Stawicki SP, Braslow BM, Panebianco NL, Kirkpatrick JN, Gracias VH, Hayden GE, et al. Intensivist Use of Hand-Carried Ultrasonography to Measure IVC Collapsibility in Estimating Intravascular Volume Status: Correlations with CVP. J Am Coll Surg. 2009;209(1):55–61.
10.Prekker ME, Scott NL, Hart D, Sprenkle MD, Leatherman JW. Point-of-care ultrasound to estimate central venous pressure: a comparison of three techniques. Crit Care Med. 2013 Mar;41(3):833-41.
11.Scales K. Central venous pressure monitoring in clinical practice. Nurs Stand. 2010;24(29):49-55;quiz 56.
12.Ruesch S, Walder B, Tramèr MR. Complications of central venous catheters: Internal jugular versus subclavian access - A systematic review. Crit Care Med. 2002;30(2):454–60.
13.Maecken T, Grau T. Ultrasound imaging in vascular access. Crit Care Med. 2007 May;35(5 Suppl): S178-85.
14.Krause I, Birk E, Davidovits M, Cleper R, Blieden L, Pinhas L, et al. Inferior vena cava diameter: A useful method for estimation of fluid status in children on haemodialysis. Nephrol Dial Transplant. 2001;16(6):1203–6.
Published
2021-12-13
How to Cite
SINGH, Deepak Raj et al.
Correlation of Inferior Vena Cava diameter and IVC Collapsibility Index with central venous pressure (CVP) in critically ill surgical patients.
J Soc Surg Nep, [S.l.], v. 24, n. 1, p. 19-22, dec. 2021.
ISSN 2392-4772.
Available at: <https://jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=465>. Date accessed: 01 dec. 2023.
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