Measurement site of inferior vena cava ...
Document type :
Article dans une revue scientifique
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Title :
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
Author(s) :
Caplan, Morgan [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Durand, Arthur [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bortolotti, Perrine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Colling, Delphine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
GOUTAY, Julien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Duburcq, Thibault [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Drumez, Elodie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Rouze, Anahita [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Nseir, Saad [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Howsam, Michael [Auteur]
Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167
Onimus, Thierry [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Favory, Raphael [Auteur]
Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167
Preau, Sebastien [Auteur]
Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Durand, Arthur [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bortolotti, Perrine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Colling, Delphine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
GOUTAY, Julien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Duburcq, Thibault [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Drumez, Elodie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Rouze, Anahita [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Nseir, Saad [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Howsam, Michael [Auteur]
Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167
Onimus, Thierry [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Favory, Raphael [Auteur]
Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167
Preau, Sebastien [Auteur]
Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167
Journal title :
Annals of Intensive Care
Abbreviated title :
Ann. Intensive Care
Volume number :
10
Publisher :
Springer Science and Business Media LLC
Publication date :
2020-12
ISSN :
2110-5820
English keyword(s) :
Inferior vena cava
Fluids
Fluid responsiveness
Hemodynamic
Sepsis
Severe infection
Ultrasound
Echocardiography
Collapsibility index
Spontaneous breathing
Fluids
Fluid responsiveness
Hemodynamic
Sepsis
Severe infection
Ultrasound
Echocardiography
Collapsibility index
Spontaneous breathing
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Abstract
Background
The collapsibility index of the inferior vena cava (cIVC) has potential for predicting fluid responsiveness in spontaneously breathing patients, but a standardized ...
Show more >Abstract 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 < 0.001 and < 0.0001, respectively). Measuring inferior vena cava diameters 4 cm caudal to the right atrium predicted fluid responsiveness with the best accuracy. At this site, a standardized breathing manoeuvre also significantly improved predictive power: areas under ROC curves [mean and (95% CI)] for cIVC-ns = 0.85 [0.78–0.94] versus cIVC-st = 0.98 [0.97–1.0], p < 0.001. When cIVC-ns is superior or equal to 33%, fluid responsiveness is predicted with a sensitivity of 66% and a specificity of 92%. When cIVC-st is superior or equal to 44%, fluid responsiveness is predicted with a sensitivity of 93% and a specificity of 98%. 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.Show less >
Show more >Abstract 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 < 0.001 and < 0.0001, respectively). Measuring inferior vena cava diameters 4 cm caudal to the right atrium predicted fluid responsiveness with the best accuracy. At this site, a standardized breathing manoeuvre also significantly improved predictive power: areas under ROC curves [mean and (95% CI)] for cIVC-ns = 0.85 [0.78–0.94] versus cIVC-st = 0.98 [0.97–1.0], p < 0.001. When cIVC-ns is superior or equal to 33%, fluid responsiveness is predicted with a sensitivity of 66% and a specificity of 92%. When cIVC-st is superior or equal to 44%, fluid responsiveness is predicted with a sensitivity of 93% and a specificity of 98%. 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.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CNRS
CNRS
Research team(s) :
Glycobiology in fungal Pathogenesis and Clinical Applications
Submission date :
2021-07-15T09:22:11Z
2021-07-16T13:41:14Z
2021-07-16T13:41:14Z
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