| Title |
Respiratory changes of the inferior vena cava diameter predict fluid responsiveness in spontaneously breathing patients with cardiac arrhythmias
|
|---|---|
| Published in |
Annals of Intensive Care, August 2018
|
| DOI | 10.1186/s13613-018-0427-1 |
| Pubmed ID | |
| Authors |
Perrine Bortolotti, Delphine Colling, Vincent Colas, Benoit Voisin, Florent Dewavrin, Julien Poissy, Patrick Girardie, Maeva Kyheng, Fabienne Saulnier, Raphael Favory, Sebastien Preau |
| Abstract |
Whether the respiratory changes of the inferior vena cava diameter during a deep standardized inspiration can reliably predict fluid responsiveness in spontaneously breathing patients with cardiac arrhythmia is unknown. This prospective two-center study included nonventilated arrhythmic patients with infection-induced acute circulatory failure. Hemodynamic status was assessed at baseline and after a volume expansion of 500 mL 4% gelatin. The inferior vena cava diameters were measured with transthoracic echocardiography using the bi-dimensional mode on a subcostal long-axis view. Standardized respiratory cycles consisted of a deep inspiration with concomitant control of buccal pressures and passive exhalation. The collapsibility index of the inferior vena cava was calculated as [(expiratory-inspiratory)/expiratory] diameters. Among the 55 patients included in the study, 29 (53%) were responders to volume expansion. The areas under the ROC curve for the collapsibility index and inspiratory diameter of the inferior vena cava were both of 0.93 [95% CI 0.86; 1]. A collapsibility index ≥ 39% predicted fluid responsiveness with a sensitivity of 93% and a specificity of 88%. An inspiratory diameter < 11 mm predicted fluid responsiveness with a sensitivity of 83% and a specificity of 88%. A correlation between the inspiratory effort and the inferior vena cava collapsibility was found in responders but was absent in nonresponder patients. In spontaneously breathing patients with cardiac arrhythmias, the collapsibility index and inspiratory diameter of the inferior vena cava assessed during a deep inspiration may be noninvasive bedside tools to predict fluid responsiveness in acute circulatory failure related to infection. These results, obtained in a small and selected population, need to be confirmed in a larger-scale study before considering any clinical application. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| France | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 55 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 55 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 8 | 15% |
| Researcher | 5 | 9% |
| Student > Master | 5 | 9% |
| Other | 3 | 5% |
| Student > Ph. D. Student | 3 | 5% |
| Other | 12 | 22% |
| Unknown | 19 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 25 | 45% |
| Nursing and Health Professions | 5 | 9% |
| Agricultural and Biological Sciences | 1 | 2% |
| Social Sciences | 1 | 2% |
| Engineering | 1 | 2% |
| Other | 0 | 0% |
| Unknown | 22 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 May 2019.
All research outputs
#15,316,816
of 23,552,911 outputs
Outputs from Annals of Intensive Care
#809
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Outputs of similar age
#200,246
of 332,159 outputs
Outputs of similar age from Annals of Intensive Care
#9
of 12 outputs
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