Publication: Inferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis
Issued Date
2016-12-01
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ISSN
15578615
08839441
08839441
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2-s2.0-84995578375
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Critical Care. Vol.36, (2016), 246-251
Suggested Citation
Pongdhep Theerawit, Thotsaporn Morasert, Yuda Sutherasan Inferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis. Journal of Critical Care. Vol.36, (2016), 246-251. doi:10.1016/j.jcrc.2016.07.023 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/40963
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Title
Inferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis
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Abstract
© 2016 Elsevier Inc. Background Currently, physicians employ pulse pressure variation (PPV) as a gold standard for predicting fluid responsiveness. However, employing ultrasonography in intensive care units is increasing, including using the ultrasonography for assessment of fluid responsiveness. Data comparing the performance of both methods are still lacking. This is the reason for the present study. Materials and methods We conducted a prospective observational study in patients with sepsis requiring fluid challenge. The PPV, inferior vena cava diameter variation (IVDV), stroke volume variation (SVV), and the other hemodynamic variables were recorded before and after fluid challenges. Fluid responders were identified when cardiac output increased more than 15% after fluid loading. Results A total of 29 patients with sepsis were enrolled in this study. Sixteen (55.2%) were fluid responders. Threshold values to predict fluid responsiveness were 13.8% of PPV (sensitivity 100% and specificity 84.6%), 10.2% of IVDV (sensitivity 75% and specificity 76.9%) and 10.7% of SVV (sensitivity 81.3% and specificity 76.9%). The area under the curves of receiver operating characteristic showed that PPV (0.909, 95% confidence interval [CI], 0.784-1.00) and SVV (0.812, 95% CI, 0.644-0.981) had greater performance than IVDV (0.688, 95% CI, 0.480-0.895) regarding fluid responsiveness assessment. Conclusions The present study demonstrated better performance of the PPV than the IVDV. A threshold value more than 10% may be used for identifying fluid responders.