Automated Inferior Vena Cava Distensibility Index for Assessing Fluid Responsiveness in Ventilated Patients After...

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.

Prospective, descriptive, single-center study.

A single tertiary academic center.

Fifty consecutive after cardiac surgery.

We compared (1) the automated echocardiographic method with (2) the stroke volume variation (SVV) technique and (3) the manual echocardiographic method.

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.

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.

Among cardiac surgical patients, manual IVC-DI correlated significantly with SVV in assessing FR. However, the automated IVC-DI mode demonstrated less reliability.