Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients

Abstract

Our study suggests that respiratory change in IVC diameter is an accurate predictor of fluid responsiveness in septic patients.

Hemodynamic instability and fluid responsiveness

“…Using a subxiphoid view in completely passive patients with mechanical ventilation, inferior vena cava respiratory variation has been associated with a positive fluid responsiveness, 27,28 as shown in the current case and in Fig. 4.…”

The use of Tricuspid Annular Plane Systolic Excursion and Tissue Doppler Imaging Velocities for the Estimation of Pulmonary Hypertension and Right Ventricular Function in Mechanically Ventilated Patients

“…It seems that since the normal respiratory augmentation in venous return is limited by RV enlargement, normal IVC diameter variations are reduced, increasing diagnostic accuracy of this technique. Furthermore, measurement of distensibility index of IVC has been proposed for RAP calculation in mechanically ventilated patients (Barbier et al, 2004). Finally, traditional echocardiographic indices, such as RVFAC, are time-consuming and not always easy to perform because of difficulties to well delineate the RV endocardial border.…”

Assessment of loading conditions with cardiac ultrasound. A comprehensive review

“…With transthoracic echocardiography, it is easy to demonstrate the dilation and decrease of diameter of the inferior caval vein (IVC) with inspiration and expiration, respectively. Barbier et al and M Feissel et al demonstrated clearly that respiratory variation of the IVC reliably predicts fluid responsiveness [20,21]. Conversely, in acutely decompensated heart failure patients, the rate of fluid withdrawal during haemodialysis can be guided by intermittent evaluation of the respiratory induced alterations of the IVC diameters [22].…”