Abstract
Early optimization of fluid status is of central importance in the treatment of critically
ill patients. This study aims to investigate whether inferior vena cava (IVC) diameters
correlate with invasively assessed hemodynamic parameters and whether this approach
may thus contribute to an early, non-invasive evaluation of fluid status. Thirty mechanically
ventilated patients with severe sepsis or septic shock (age 60 ± 15 years; APACHE-II
score 31 ± 8; 18 male) were included. IVC diameters were measured throughout the respiratory
cycle using transabdominal ultrasonography. Consecutively, volume-based hemodynamic
parameters were determined using the single-pass thermal transpulmonary dilution technique.
This was a prospective study in a tertiary care academic center with a 24-bed medical
intensive care unit (ICU) and a 14-bed anesthesiological ICU. We found a statistically
significant correlation of both inspiratory and expiratory IVC diameter with central
venous pressure (p = 0.004 and p = 0.001, respectively), extravascular lung water index (p = 0.001, p < 0.001, respectively), intrathoracic blood volume index (p = 0.026, p = 0.05, respectively), the intrathoracic thermal volume (both p < 0.001), and the PaO2/FiO2 oxygenation index (p = 0.007 and p = 0.008, respectively). In this study, IVC diameters were found to correlate with
central venous pressure, extravascular lung water index, intrathoracic blood volume
index, the intrathoracic thermal volume, and the PaO2/FiO2 oxygenation index. Therefore, sonographic determination of IVC diameter seems useful
in the early assessment of fluid status in mechanically ventilated septic patients.
At this point in time, however, IVC sonography should be used only in addition to
other measures for the assessment of volume status in mechanically ventilated septic
patients.
Keywords
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Article info
Publication history
Published online: April 02, 2008
Accepted:
November 6,
2007
Received in revised form:
August 9,
2007
Received:
April 18,
2007
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
