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Intensive Care Medicine

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01-09-2004 | Brief Report

The respiratory variation in inferior vena cava diameter as a guide to fluid therapy

Authors: Marc Feissel, Frédéric Michard, Jean-Pierre Faller, Jean-Louis Teboul

Published in: Intensive Care Medicine | Issue 9/2004

Abstract

Objective

To investigate whether the respiratory variation in inferior vena cava diameter (ΔD_IVC) could be related to fluid responsiveness in mechanically ventilated patients.

Design

Prospective clinical study.

Setting

Medical ICU of a non-university hospital.

Patients

Mechanically ventilated patients with septic shock (n=39).

Interventions

Volume loading with 8 mL/kg of 6% hydroxyethylstarch over 20 min.

Measurements and results

Cardiac output and ΔD_IVC were assessed by echography before and immediately after the standardized volume load. Volume loading induced an increase in cardiac output from 5.7±2.0 to 6.4±1.9 L/min (P<0.001) and a decrease in ΔD_IVC from 13.8±13.6 vs 5.2±5.8% (P<0.001). Sixteen patients responded to volume loading by an increase in cardiac output ≥15% (responders). Before volume loading, the ΔD_IVC was greater in responders than in non-responders (25±15 vs 6±4%, P<0.001), closely correlated with the increase in cardiac output (r=0.82, P<0.001), and a 12% ΔD_IVC cut-off value allowed identification of responders with positive and negative predictive values of 93% and 92%, respectively.

Conclusion

Analysis of ΔD_IVC is a simple and non-invasive method to detect fluid responsiveness in mechanically ventilated patients with septic shock.

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Title: The respiratory variation in inferior vena cava diameter as a guide to fluid therapy
Authors: Marc Feissel
Frédéric Michard
Jean-Pierre Faller
Jean-Louis Teboul
Publication date: 01-09-2004
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 9/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-004-2233-5

At a glance: The STEP trials

Springer Medicine

The respiratory variation in inferior vena cava diameter as a guide to fluid therapy

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusion

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