Determining the Merit of Inferior Vena Cava Distensibility Index in The Estimation of Fluid Responsiveness in Ventilated Septic Patient in Intensive Care Unit

ABSTRACT

@#Introduction: There is no single haemodynamic parameters either static central venous pressure (CVP) or dynamic stroke volume variation, inferior vena cava distensibility index (SVV,IVCd) that can be used precisely to assess fluid responsiveness. It must be performed concurrently with clinical assessment. Therefore, this study was conducted to determine the correlation between these 3 parameters. Methods: This was a cross sectional non-interventional study conducted in intensive care unit. Each patient who fulfilled the criteria will have their CVP, SVV and IVCd measured instantaneously. Analysis of correlation was done using bivariate (Pearson) correlation, while agreement between SVV and IVCd was assessed using Cohen’s Kappa analysis. Results: A total of 37 patients were enrolled in this study. 70.3% were males and 29.7% were females. Mean age was 59.7 ± 13.3. Mean APACHE score was 24.1 ± 6.1. IVCd had significant positive correlation with SVV (r = 0.391, p = 0.017). Agreement between IVCd and SVV was 0.329 (0.95 CI = 0.0174 – 0.6412; p = 0.033). There was non-significant negative correlation between IVCd with CVP and SVV with CVP with r = -0.155 (p=0.359) and r = -0.068 (p= 0.691) respectively. Conclusion: There is only fair correlation between IVCd and SVV in determining fluid responsiveness. However, CVP does not correlate to both SVV and IVCd. Neither one of them is a good method in assessing fluid responsiveness during standard care in our centre. Therefore, the usage of above methods needs to combine with clinical parameters to yield better result.