Amr Salah Omar, Praveen C Sivadasan, Suraj Sudarsanan, Hany O Ragab, Alaa Rahhal, Samy Hanoura, Sameh Aboulnaga, Abdelrahman Abdalla, Abdulwahid Almulla
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A second comparison was performed 90 to 180 minutes 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 is defined as an increase in cardiac output by more than 10% after receiving a fluid challenge.</p><p><strong>Results: </strong>A total of 50 patients who underwent cardiac surgery were included (age 51 ± 8 years; 86% males). Before the fluid challenge, a negative correlation between automated and manual IVC-DI was observed (r = -0.141; p = 0.328) with a concordance rate of 98%, although the correlation became positive after the fluid challenge (r = 0.172; p = 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 = 0.012). FR predicted by automated IVC-DI was found to have a sensitivity of 64% and specificity 49% with a receiver operating characteristic area under the curve of 0.55.</p><p><strong>Conclusions: </strong>Among cardiac surgical patients, manual IVC-DI correlated significantly with SVV in assessing FR. 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引用次数: 0
摘要
目的：本研究旨在评估下腔静脉扩张指数（IVC-DI）测量的准确性，以及随时间跟踪液体反应性（FR）的能力。设计：前瞻性、描述性、单中心研究。环境：单一的高等教育学术中心。参与者：连续50例心脏手术后患者。干预措施：我们将(1)自动超声心动图方法与(2)脑卒中容积变化（SVV）技术和(3)手动超声心动图方法进行比较。测量方法：对50例心脏手术后患者采用3种方法同时测量FR。第二次比较在90到180分钟后进行。评估的结果包括液体刺激前后SVV与自动IVC-DI和手动IVC-DI之间的相关性，以及根据自动和手动IVC-DI计算FR的准确性。FR被定义为接受液体刺激后心输出量增加超过10%。结果：共纳入50例心脏手术患者（年龄51±8岁，86%为男性）。在液体攻毒前，自动与手动IVC-DI呈负相关（r = -0.141; p = 0.328），一致性率为98%，而在液体攻毒后，相关性变为正相关（r = 0.172; p = 0.233），一致性率为98%。液体刺激后，SVV与自动IVC-DI和手动IVC-DI呈正相关，后者具有统计学意义（r = 0.352; p = 0.012）。自动IVC-DI预测FR的灵敏度为64%，特异性为49%，受试者工作特征曲线下面积为0.55。结论：在心脏外科患者中，手动IVC-DI与SVV评估FR显著相关，而自动IVC-DI模式的可靠性较低。
Automated Inferior Vena Cava Distensibility Index for Assessing Fluid Responsiveness in Ventilated Patients After Cardiac Surgery: A Prospective Pilot Comparative Study.
Objectives: 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.
Participants: Fifty consecutive after cardiac surgery.
Interventions: We compared (1) the automated echocardiographic method with (2) the stroke volume variation (SVV) technique and (3) the manual echocardiographic method.
Measurements: FR was measured simultaneously with all 3 methods in 50 patients after cardiac surgery. A second comparison was performed 90 to 180 minutes 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 is defined as an increase in cardiac output by more than 10% after receiving a fluid challenge.
Results: A total of 50 patients who underwent cardiac surgery were included (age 51 ± 8 years; 86% males). Before the fluid challenge, a negative correlation between automated and manual IVC-DI was observed (r = -0.141; p = 0.328) with a concordance rate of 98%, although the correlation became positive after the fluid challenge (r = 0.172; p = 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 = 0.012). FR predicted by automated IVC-DI was found to have a sensitivity of 64% and specificity 49% with a receiver operating characteristic area under the curve of 0.55.
Conclusions: Among cardiac surgical patients, manual IVC-DI correlated significantly with SVV in assessing FR. However, the automated IVC-DI mode demonstrated less reliability.
期刊介绍：
The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.
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