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The Sonographic Measurement of the Inferior Vena Cava Diameter versus the Central Venous Pressure in Assessing Fluid Responsiveness in Patients after Coronary Artery Bypass Graft Surgery
• 2022
Publication Information
Authors
Mohamed El-Gazzar1
, Ahmed Soubih2
, Osama Sanad3
, Hesham Rashid3
, Ashraf Elnahhas1
Keywords
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Journal
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Publisher
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Volume
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Issue
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Pages
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publication.type
Local
Paper Link
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Supplementary Materials
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Abstract
Background: Fluid status assessment and management post coronary artery bypass
grafting (CABG) is a clinical challenge. The study aimed to establish whether central
venous pressure (CVP) and ultrasound measures of respiratory variability of inferior
vena cava (IVC) diameter might predict fluid responsiveness in mechanically
ventilated patients after CABG.
Methods: This comparative study included 200 consecutive adult patients who
underwent elective CABG. We recorded the following parameters: heart rate (HR),
systolic blood pressure (SBP), diastolic blood pressure (DBP), central venous
pressure (CVP), inferior vena cava maximum (IVCmax), and minimum (IVCmin)
diameters, left ventricular ejection fraction (LVEF), and velocity-time integral in the
left ventricular outflow tract (VTI-LVOT).
Results: The age of the patients ranged from 45 to 71 years, and 147 were males
(73.5%). Patients were grouped into fluid responders (n= 135), defined as stroke
volume variation (SVV) of 15% or greater following fluid bolus administration, and
fluid non-responders (n= 65), defined SVV of less than 15% following fluid bolus
administration. There was no statistically significant difference between the groups
regarding their CVP, maximum and minimum IVC diameters, inferior vena cava
distensibility index (IVC-DI), and other markers of fluid responsiveness (p-value 0.47,
0.34, 0.59, and 0.64, respectively). There was a significant difference in SVV between
fluid responders (18.33±2.767) and non-responders (10.95±1.940) (p-value
grafting (CABG) is a clinical challenge. The study aimed to establish whether central
venous pressure (CVP) and ultrasound measures of respiratory variability of inferior
vena cava (IVC) diameter might predict fluid responsiveness in mechanically
ventilated patients after CABG.
Methods: This comparative study included 200 consecutive adult patients who
underwent elective CABG. We recorded the following parameters: heart rate (HR),
systolic blood pressure (SBP), diastolic blood pressure (DBP), central venous
pressure (CVP), inferior vena cava maximum (IVCmax), and minimum (IVCmin)
diameters, left ventricular ejection fraction (LVEF), and velocity-time integral in the
left ventricular outflow tract (VTI-LVOT).
Results: The age of the patients ranged from 45 to 71 years, and 147 were males
(73.5%). Patients were grouped into fluid responders (n= 135), defined as stroke
volume variation (SVV) of 15% or greater following fluid bolus administration, and
fluid non-responders (n= 65), defined SVV of less than 15% following fluid bolus
administration. There was no statistically significant difference between the groups
regarding their CVP, maximum and minimum IVC diameters, inferior vena cava
distensibility index (IVC-DI), and other markers of fluid responsiveness (p-value 0.47,
0.34, 0.59, and 0.64, respectively). There was a significant difference in SVV between
fluid responders (18.33±2.767) and non-responders (10.95±1.940) (p-value