Correlation of Inferior vena cava diameter, IVC index, and central venous pressure in adult patients presenting with shock at the emergency room, Sena hospital
Keywords:
Hemodynamic evaluation, inferior vena cava diameter, IVC indexAbstract
This is a prospective double-blind observational study conducted in the emergency room of a secondary care center. The objective is to assess the correlation between inferior vena cava diameters (IVCmax), IVC collapsibility index and central venous pressure (CVP) for estimating the volume status in shock patients. The study was performed at the emergency room of Sena hospital during April - September 2021. All adult patients who presented with shock and had a central venous catheter insertion performed were enrolled. The IVC index was calculated as a relative decrease in the IVC diameter during respiratory cycle which was measured by emergency physician using abdominal ultrasound. The correlation of CVP and IVCmax was calculated by Pearson’s Correlation Coefficient (r) and the correlation of CVP and IVC index was calculated by Spearman Correlation Coefficient (rs)
Result: A total of 22/31 (71.0%) females and 9/31 (29.0%) males were included in the study with a mean age of 61.8 years old (SD = 12.4).17/31 (54.8%) were intubated and 14/31 (45.2%) were not intubated. The summary statistics that were generated for the participants’ characteristics were divided into CVP <10 cmH2O, 10-15 cmH2O and > 15 cmH2O. The correlation of the CVP measurement and the IVC index was r=-0.361 (P = 0.046). However there was no correlation between CVP and the end-expiratory IVC diameter alone; r = 0.299 (p = 0.012). The study also showed that the sensitivity, specificity and accuracy of the IVC index to predict CVP were 90.48%, 40% and 74.19% respectively.
Conclusion: The IVC index calculated from the IVC diameter measured by bedside ultrasound in the emergency room has a good correlation with CVP
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