scholarly journals Preoperative and Postoperative Assessment of Ultrasonographic Measurement of Inferior Vena Cava: A Prospective, Observational Study

2018 ◽  
Vol 7 (6) ◽  
pp. 145
Author(s):  
Ayhan Kaydu ◽  
Erhan Gokcek
Keyword(s):  
Observational Study ◽  
Inferior Vena Cava ◽  
Prospective Observational Study ◽  
Inferior Vena ◽  
Vena Cava ◽  
Postoperative Assessment

scholarly journals Assessment of inferior vena cava diameter by echocardiography in normal Indian population: A prospective observational study

2016 ◽  
Vol 68 ◽  
pp. S26-S30 ◽  
Author(s):  
Shivanand Patil ◽  
Santosh Jadhav ◽  
Natraj Shetty ◽  
Jayashree Kharge ◽  
Beeresha Puttegowda ◽  
...  
Keyword(s):  
Observational Study ◽  
Inferior Vena Cava ◽  
Prospective Observational Study ◽  
Indian Population ◽  
Inferior Vena ◽  
Vena Cava ◽  
Inferior Vena Cava Diameter

scholarly journals Preoperative and Postoperative Assessment of Ultrasonographic Measurement of Inferior Vena Cava: a Prospective, Observational Study

2018 ◽  
Author(s):  
Ayhan Kaydu ◽  
Erhan Gökçek
Keyword(s):  
Observational Study ◽  
Inferior Vena Cava ◽  
Postoperative Period ◽  
Prospective Observational Study ◽  
Inferior Vena ◽  
Vena Cava ◽  
Average Diameter ◽  
Adult Patients ◽  
Ultrasound Measurement ◽  
American Society

Background: Ultrasound measurement of dynamic changes in inferior vena cava (IVC) diameter and collapsibility index (CI) evaluates to estimate the fluid responsiveness and intravascular volume status. We conducted a analysis to quantify the sonographic measurement of IVC diameter changes in adult patients at preoperative and postoperative period. Methods: Ultrasonography was performed on 72 patients scheduled for surgery with American Society of Anesthesiologists physical status I to III. Quantitative assessments of the end-expiration (Dmin), end-inspiration (Dmax) and CI at preoperative and postoperative period were compared in a prospective, observational study. The patients received intravenous fluid according to standard protocol regimes peroperatively. The cutt-off value of dIVC 40% was accepted as hypovolemia. Results: Ultrasonography of IVC measurement was unsuccessful in 12.5% of patients and 63 patients remained for analyses. The mean age was 43.29 ± 17.22 (range 18 - 86) years. The average diameter of the Dmin, Dmax and dIVC at preoperative and postoperative were 1.99 ± 0.31 vs. 2.05 ± 0.29 cm, 1.72 ± 0.33 vs. 1.74 ± 0.32 cm, 14.0 ± 9.60 % vs. 15.14 ± 11.18 %, respectively (p<0.05). Using a threshold dIVC of 40%, one patient preoperatively and 5 postoperatively were hypovolemic (p<0.05). CI was also positively associated preoperatively and postoperatively (regression coefficient = 0.438, p<0.01). Conclusion: The diameter of IVC did not change preoperatively and postoperatively in adult patients with standard fluid regimens. The parameters of the IVC diameter increased postoperatively according to preoperative period.

scholarly journals Role of inferior vena cava collapsibility index in the prediction of hypotension associated with general anesthesia: an observational study

2019 ◽  
Author(s):  
Marcell Szabó ◽  
Anna Bozó ◽  
Katalin Darvas ◽  
Alexandra Horváth ◽  
Zsolt Dániel Iványi
Keyword(s):  
Observational Study ◽  
Inferior Vena Cava ◽  
General Anesthesia ◽  
Roc Curve ◽  
Inferior Vena ◽  
Vena Cava ◽  
Systolic Pressure ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Collapsibility Index

Abstract Background: Intraoperative hypotension increases 30-day mortality and the risks of myocardial injury and acute renal failure. Patients with inadequate volume reserve before the induction of anesthesia are highly exposed. The identification of latent hypovolemia is therefore crucial. Ultrasonographic measurement of the inferior vena cava collapsibility index (IVCCI) is able to detect volume responsiveness in circulatory shock. No current evidence is available regarding whether preoperative measurement of the IVCCI could identify patients at high risk for hypotension associated with general anesthesia. Methods: A total of 102 patients undergoing elective general surgery under general anesthesia with standardized propofol induction were recruited for this prospective observational study. The IVCCI was measured under spontaneous breathing. A collapsing (IVCCI≧50%) (CI+) and a noncollapsing (CI-) group were formed. Immediate postinduction changes in systolic and mean blood pressure were compared. The performance of the IVCCI as a diagnostic tool for predicting hypotension (systolic pressure <90 mmHg or a ≥30% drop from the baseline) was evaluated by ROC curve analysis. Results: A total of 83 patients were available for analysis, with 20 in the CI+ and 63 in the CI- group, we excluded 19 previously eligible patients due to inadequate visualization of the IVC (7 cases), lack of adherence to the protocol (8 cases), missing data (2 cases) or change in anesthesiologic management (2 cases). The mean decrease in systolic pressure in the CI+ group was 53.8±15.3 compared to 35.8±18.1 mmHg in CI- patients (P=0.0001). The relative mean arterial pressure change medians were 34.1% (IQR 23.2%-43.0%) and 24.2% (IQR 17.2%-30.2%), respectively (P=0.0029). The ROC curve analysis for IVCCI showed an AUC of 64.8% (95%CI 52.1-77.5%). The selected 50% level of the IVCCI had a sensitivity of only 45.5% (95%CI 28.1-63.7%), but the specificity was high at 90.0% (78.2-96.7%). The positive predictive value was 75.0% (95%CI 50.9-91.3%), and the negative predictive value was 71.4% (95%CI 58.7-82.1%). Conclusion: In spontaneously breathing preoperative noncardiac surgical patients, preoperatively detected IVCCI≧50% can predict postinduction hypotension with high specificity but low sensitivity. Despite moderate performance, IVCCI is an easy, noninvasive and attractive option to identify patients at risk and should be explored further.

scholarly journals Role of inferior vena cava collapsibility index in the prediction of hypotension associated with general anesthesia: an observational study

2019 ◽  
Author(s):  
Marcell Szabó ◽  
Anna Bozó ◽  
Katalin Darvas ◽  
Alexandra Horváth ◽  
Zsolt Dániel Iványi
Keyword(s):  
Observational Study ◽  
Inferior Vena Cava ◽  
General Anesthesia ◽  
Roc Curve ◽  
Inferior Vena ◽  
Vena Cava ◽  
Systolic Pressure ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Collapsibility Index

Abstract Background: Intraoperative hypotension increases 30-day mortality and the risks of myocardial injury and acute renal failure. Patients with inadequate volume reserve before the induction of anesthesia are highly exposed. The identification of latent hypovolemia is therefore crucial. Ultrasonographic measurement of the inferior vena cava collapsibility index (IVCCI) is able to detect volume responsiveness in circulatory shock. No current evidence is available regarding whether preoperative measurement of the IVCCI could identify patients at high risk for hypotension associated with general anesthesia. Methods: A total of 102 patients undergoing elective general surgery under general anesthesia with standardized propofol induction were recruited for this prospective observational study. The IVCCI was measured under spontaneous breathing. A collapsing (IVCCI≧50%) (CI+) and a noncollapsing (CI-) group were formed. Immediate postinduction changes in systolic and mean blood pressure were compared. The performance of the IVCCI as a diagnostic tool for predicting hypotension (systolic pressure <90 mmHg or a ≥30% drop from the baseline) was evaluated by ROC curve analysis. Results: A total of 83 patients were available for analysis, with 20 in the CI+ and 63 in the CI- group, we excluded 19 previously eligible patients due to inadequate visualization of the IVC (7 cases), lack of adherence to the protocol (8 cases), missing data (2 cases) or change in anesthesiologic management (2 cases). The mean decrease in systolic pressure in the CI+ group was 53.8±15.3 compared to 35.8±18.1 mmHg in CI- patients (P=0.0001). The relative mean arterial pressure change medians were 34.1% (IQR 23.2%-43.0%) and 24.2% (IQR 17.2%-30.2%), respectively (P=0.0029). The ROC curve analysis for IVCCI showed an AUC of 64.8% (95%CI 52.1-77.5%). The selected 50% level of the IVCCI had a sensitivity of only 45.5% (95%CI 28.1-63.7%), but the specificity was high at 90.0% (78.2-96.7%). The positive predictive value was 75.0% (95%CI 50.9-91.3%), and the negative predictive value was 71.4% (95%CI 58.7-82.1%). Conclusion: In spontaneously breathing preoperative noncardiac surgical patients, preoperatively detected IVCCI≧50% can predict postinduction hypotension with high specificity but low sensitivity. Despite moderate performance, IVCCI is an easy, noninvasive and attractive option to identify patients at risk and should be explored further.

scholarly journals Role of inferior vena cava collapsibility index in the prediction of hypotension associated with general anesthesia: an observational study

2019 ◽  
Author(s):  
Marcell Szabó ◽  
Anna Bozó ◽  
Katalin Darvas ◽  
Alexandra Horváth ◽  
Zsolt Dániel Iványi
Keyword(s):  
Observational Study ◽  
Inferior Vena Cava ◽  
General Anesthesia ◽  
Roc Curve ◽  
Inferior Vena ◽  
Vena Cava ◽  
Systolic Pressure ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Collapsibility Index

Abstract Background: Intraoperative hypotension increases 30-day mortality and the risks of myocardial injury and acute renal failure. Patients with inadequate volume reserve before the induction of anesthesia are highly exposed. The identification of latent hypovolemia is therefore crucial. Ultrasonographic measurement of the inferior vena cava collapsibility index (IVCCI) is able to detect volume responsiveness in circulatory shock. No current evidence is available regarding whether preoperative measurement of the IVCCI could identify patients at high risk for hypotension associated with general anesthesia. Methods: A total of 102 patients undergoing elective general surgery under general anesthesia with standardized propofol induction were recruited for this prospective observational study. The IVCCI was measured under spontaneous breathing. A collapsing (IVCCI≧50%) (CI+) and a noncollapsing (CI-) group were formed. Immediate postinduction changes in systolic and mean blood pressure were compared. The performance of the IVCCI as a diagnostic tool for predicting hypotension (systolic pressure <90 mmHg or a ≥30% drop from the baseline) was evaluated by ROC curve analysis. Results: A total of 83 patients were available for analysis, with 20 in the CI+ and 63 in the CI- group, we excluded 19 previously eligible patients due to inadequate visualization of the IVC (7 cases), lack of adherence to the protocol (8 cases), missing data (2 cases) or change in anesthesiologic management (2 cases). The mean decrease in systolic pressure in the CI+ group was 53.8±15.3 compared to 35.8±18.1 mmHg in CI- patients (P=0.0001). The relative mean arterial pressure change medians were 34.1% (IQR 23.2%-43.0%) and 24.2% (IQR 17.2%-30.2%), respectively (P=0.0029). The ROC curve analysis for IVCCI showed an AUC of 64.8% (95%CI 52.1-77.5%). The selected 50% level of the IVCCI had a sensitivity of only 45.5% (95%CI 28.1-63.7%), but the specificity was high at 90.0% (78.2-96.7%). The positive predictive value was 75.0% (95%CI 50.9-91.3%), and the negative predictive value was 71.4% (95%CI 58.7-82.1%). Conclusion: In spontaneously breathing preoperative noncardiac surgical patients, preoperatively detected IVCCI≧50% can predict postinduction hypotension with high specificity but low sensitivity. Despite moderate performance, IVCCI is an easy, noninvasive and attractive option to identify patients at risk and should be explored further.

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