Measurement site of inferior vena cava diameter affects the accuracy with which fluid responsiveness can be predicted in spontaneously breathing patients: a post hoc analysis of two prospective cohorts

Autor: Anahita Rouzé, Elodie Drumez, Mike Howsam, Arthur Durand, Raphael Favory, Delphine Colling, Morgan Caplan, Thibault Duburcq, Saad Nseir, Perrine Bortolotti, Julien Goutay, Sebastien Preau, Thierry Onimus
Přispěvatelé: Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Lille, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), This study was supported by the academic hospital of Lille., CNRS, Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille], METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694, Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167, Université de Lille, LillOA, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille
Rok vydání: 2020
Předmět:
medicine.medical_specialty
[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging
Hemodynamics
Fluid responsiveness
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
Inferior vena cava
Sepsis
03 medical and health sciences
0302 clinical medicine
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Internal medicine
Ultrasound
medicine
Hemodynamic
10. No inequality
Fluids
Receiver operating characteristic
Inhalation
business.industry
Severe infection
Research
lcsh:Medical emergencies. Critical care. Intensive care. First aid
030208 emergency & critical care medicine
Echocardiography
Collapsibility index
Spontaneous breathing
Stroke volume
lcsh:RC86-88.9
medicine.disease
[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
[SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging
medicine.vein
Breathing
Cardiology
business
Zdroj: Annals of Intensive Care
Annals of Intensive Care, 2020, 10, pp.168. ⟨10.1186/s13613-020-00786-1⟩
Annals of Intensive Care, Vol 10, Iss 1, Pp 1-10 (2020)
Annals of Intensive Care, SpringerOpen, 2020, 10, pp.168. ⟨10.1186/s13613-020-00786-1⟩
ISSN: 2110-5820
DOI: 10.1186/s13613-020-00786-1⟩
Popis: Background The collapsibility index of the inferior vena cava (cIVC) has potential for predicting fluid responsiveness in spontaneously breathing patients, but a standardized approach for measuring the inferior vena cava diameter has yet to be established. The aim was to test the accuracy of different measurement sites of inferior vena cava diameter to predict fluid responsiveness in spontaneously breathing patients with sepsis-related circulatory failure and examine the influence of a standardized breathing manoeuvre. Results Among the 81 patients included in the study, the median Simplified Acute Physiologic Score II was 34 (24; 42). Sepsis was of pulmonary origin in 49 patients (60%). Median volume expansion during the 24 h prior to study inclusion was 1000 mL (0; 2000). Patients were not severely ill: none were intubated, only 20% were on vasopressors, and all were apparently able to perform a standardized breathing exercise. Forty-one (51%) patients were responders to volume expansion (i.e. a ≥ 10% stroke volume index increase). The cIVC was calculated during non-standardized (cIVC-ns) and standardized breathing (cIVC-st) conditions. The accuracy with which both cIVC-ns and cIVC-st predicted fluid responsiveness differed significantly by measurement site (interaction p p Conclusion The accuracy with which cIVC measurements predict fluid responsiveness in spontaneously breathing patients depends on both the measurement site of inferior vena cava diameters and the breathing regime. Measuring inferior vena cava diameters during a standardized inhalation manoeuvre at 4 cm caudal to the right atrium seems to be the method by which to obtain cIVC measurements best-able to predict patients’ response to volume expansion.
Databáze: OpenAIRE
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