Top

Critical Care

Published in:

Open Access 01-12-2018 | Research

Value of variation index of inferior vena cava diameter in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation: a systematic review and meta-analysis

Authors: Haijun Huang, Qinkang Shen, Yafen Liu, Hua Xu, Yixin Fang

Published in: Critical Care | Issue 1/2018

Abstract

Background

Respiratory variations in the inferior vena cava diameter (ΔIVCD) have been studied extensively with respect to their value in predicting fluid responsiveness, but the results are conflicting. The aim of this meta-analysis was to explore the value of ΔIVCD for predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation.

Methods

PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched up to June 2017. The diagnostic OR (DOR), sensitivity, and specificity were calculated. The summary ROC curve was estimated, and the area under the ROC curve (AUROC) was calculated.

Results

Overall, 603 patients were included in this review, 324 (53.7%) of whom were fluid-responsive. The cutoff values of ΔIVCD varied across studies, ranging from 8% to 21%. Heterogeneity between studies was assessed with an overall Q = 0.069, I² = 0%, and P = 0.483. The pooled sensitivity and specificity for the overall population were 0.69 (95% CI, 0.51–0.83) and 0.80 (95% CI, 0.66–0.89), respectively. The DOR was 9.28 (95% CI, 2.33–36.98). AUROCs were reported in five studies. Overall, the pooled AUROC was 0.82 (95% CI, 0.79–0.85).

Conclusions

The findings of this study suggest that the ΔIVCD performed moderately well in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation.

Available only for authorised users

Bindels AJ, van der Hoeven JG, Graafland AD, de Koning J, Meinders AE. Relationships between volume and pressure measurements and stroke volume in critically ill patients. Crit Care. 2000;4:193–9. https://doi.org/10.1186/cc693.CrossRefPubMedPubMedCentral

Hu B, Xiang H, Liang H, Yu L, Xu T, Yang JH, et al. Assessment effect of central venous pressure in fluid resuscitation in the patients with shock: a multi-center retrospective research. Chin Med J. 2013;126:1844–9.PubMed

Pinsky MR. Functional haemodynamic monitoring. Curr Opin Crit Care. 2014;20:288–93. https://doi.org/10.1097/mcc.0000000000000090.CrossRefPubMedPubMedCentral

Lee CW, Kory PD, Arntfield RT. Development of a fluid resuscitation protocol using inferior vena cava and lung ultrasound. J Crit Care. 2016;31:96–100. https://doi.org/10.1016/j.jcrc.2015.09.016.CrossRefPubMed

Cheriex EC, Leunissen KM, Janssen JH, Mooy JM, van Hooff JP. Echography of the inferior vena cava is a simple and reliable tool for estimation of ‘dry weight’ in haemodialysis patients. Nephrol Dial Transplant. 1989;4:563–8.PubMed

Ando Y, Yanagiba S, Asano Y. The inferior vena cava diameter as a marker of dry weight in chronic hemodialyzed patients. Artif Organs. 1995;19:1237–42.CrossRefPubMed

Lyon M, Blaivas M, Brannam L. Sonographic measurement of the inferior vena cava as a marker of blood loss. Am J Emerg Med. 2005;23:45–50.CrossRefPubMed

Sefidbakht S, Assadsangabi R, Abbasi HR, Nabavizadeh A. Sonographic measurement of the inferior vena cava as a predictor of shock in trauma patients. Emerg Radiol. 2007;14:181–5. https://doi.org/10.1007/s10140-007-0602-4.CrossRefPubMed

Barbier C, Loubieres Y, Schmit C, Hayon J, Ricome JL, Jardin F, et al. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30:1740–6. https://doi.org/10.1007/s00134-004-2259-8.PubMedCrossRef

10.

Feissel M, Michard F, Faller JP, Teboul JL. The respiratory variation in inferior vena cava diameter as a guide to fluid therapy. Intensive Care Med. 2004;30:1834–7. https://doi.org/10.1007/s00134-004-2233-5.CrossRefPubMed

11.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8:336–41. https://doi.org/10.1016/j.ijsu.2010.02.007.CrossRefPubMed

12.

Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155:529–36. https://doi.org/10.7326/0003-4819-155-8-201110180-00009.CrossRefPubMed

13.

Deeks JJ. Systematic reviews in health care: systematic reviews of evaluations of diagnostic and screening tests. BMJ. 2001;323:157–62.CrossRefPubMedPubMedCentral

14.

Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM. The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol. 2003;56:1129–35.CrossRefPubMed

15.

Deeks JJ, Macaskill P, Irwig L. The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol. 2005;58:882–93. https://doi.org/10.1016/j.jclinepi.2005.01.016.CrossRefPubMed

16.

Charbonneau H, Riu B, Faron M, Mari A, Kurrek MM, Ruiz J, et al. Predicting preload responsiveness using simultaneous recordings of inferior and superior vena cavae diameters. Crit Care. 2014;18:473. https://doi.org/10.1186/s13054-014-0473-5.CrossRefPubMedPubMedCentral

17.

Theerawit P, Morasert T, Sutherasan Y. Inferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis. J Crit Care. 2016;36:246–51. https://doi.org/10.1016/j.jcrc.2016.07.023.CrossRefPubMed

18.

Lu N, Xi X, Jiang L, Yang D, Yin K. Exploring the best predictors of fluid responsiveness in patients with septic shock. Am J Emerg Med. 2017;35:1258–61. https://doi.org/10.1016/j.ajem.2017.03.052.CrossRefPubMed

19.

Vignon P, Repesse X, Begot E, Leger J, Jacob C, Bouferrache K, et al. Comparison of echocardiographic indices used to predict fluid responsiveness in ventilated patients. Am J Respir Crit Care Med. 2017;195:1022–32. https://doi.org/10.1164/rccm.201604-0844OC.CrossRefPubMed

20.

Long E, Oakley E, Duke T, Babl FE. Does respiratory variation in inferior vena cava diameter predict fluid responsiveness: a systematic review and meta-analysis. Shock 2017;47:550-559. https://doi.org/https://doi.org/10.1097/shk.0000000000000801

21.

Zhang Z, Xu X, Ye S, Xu L. Ultrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis. Ultrasound Med Biol. 2014;40:845–53. https://doi.org/10.1016/j.ultrasmedbio.2013.12.010.CrossRefPubMed

Title: Value of variation index of inferior vena cava diameter in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation: a systematic review and meta-analysis
Authors: Haijun Huang
Qinkang Shen
Yafen Liu
Hua Xu
Yixin Fang
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2018
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-018-2063-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Value of variation index of inferior vena cava diameter in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Histidine-rich glycoprotein as an excellent biomarker for sepsis and beyond

Effects of hyperoxia on vascular tone in animal models: systematic review and meta-analysis

We should avoid the term “fluid overload”

Inhaled amikacin for severe Gram-negative pulmonary infections in the intensive care unit: current status and future prospects

Evidence is stronger than you think: a meta-analysis of vitamin C use in patients with sepsis

A novel method of blind bedside placement of postpyloric tubes