Automated inferior vena cava distensibility index for assessing fluid responsiveness in ventilated patients after cardiac surgery: a prospective pilot comparative study
<h3>Objectives</h3><p dir="ltr">This study aimed to assess the accuracy of inferior vena cava distensibility index (IVC-DI) measurements, as well as the ability to track fluid responsiveness (FR) over time. </p><h3>Design</h3><p dir="ltr">...
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2025
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| Summary: | <h3>Objectives</h3><p dir="ltr">This study aimed to assess the accuracy of inferior vena cava distensibility index (IVC-DI) measurements, as well as the ability to track fluid responsiveness (FR) over time. </p><h3>Design</h3><p dir="ltr">Prospective, descriptive, single-center study </p><h3>Setting</h3><p dir="ltr">Single tertiary academic center. </p><h3>Participants</h3><p dir="ltr">Fifty consecutive after cardiac surgery. </p><h3>Interventions</h3><p dir="ltr">We compared 1) the automated echocardiographic method with 2) the stroke volume variation (SVV) technique and 3) the manual echocardiographic method. </p><h3>Measurements</h3><p dir="ltr">FR was measured simultaneously with all three methods in 50 patients after cardiac surgery. A second comparison was performed 90–180 min later. The outcomes assessed included the correlations between SVV with the automated IVC-DI and the manual IVC-DI, respectively before and after fluid challenge, as well as the accuracy of FR according to the automated and manual IVC-DI. FR was defined as an increase in cardiac output (CO) by more than 10% after receiving a fluid challenge. </p><h3>Results</h3><p dir="ltr">A total of 50 patients who underwent cardiac surgery were included (age 51 ± 8 years, male gender 86%). Before the fluid challenge, a negative correlation between automated and manual IVC-CI was observed (r= -0.141, p-value= 0.328) with a concordance rate of 98%, while the correlation became positive after fluid challenge (r= 0.172, p-value= 0.233) with a concordance rate of 98%. After fluid challenge, SVV correlation with automated IVC-DI and manual IVC-DI was positive, with the latter being statistically significant (r= 0.352, p-value= 0.012). FR predicted by automated IVC-DI was found to have a sensitivity 64% and specificity 49% of with ROC area under the curve of 0.55. </p><h3>Conclusions</h3><p dir="ltr">Among cardiac surgical patients, manual IVC-DI correlated significantly with SVV in assessing fluid responsiveness. However, the automated IVC-DI mode demonstrated less reliability.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Cardiothoracic and Vascular Anesthesia<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1053/j.jvca.2025.08.023" target="_blank">https://dx.doi.org/10.1053/j.jvca.2025.08.023</a></p> |
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