Correlation of Ultrasound Guided Measurement of Inferior Vena Cava Diameter to Central Venous Pressure to Assess the Volume Status in Septic Shock of Mechanically Ventilated Patients

Abstract

Background: In the intensive care unit, making decisions about fluid treatment is one of the most difficult tasks that physicians encounter on an everyday basis. Nearly all physicians concur that hypovolemia and volume overload both raise morbidity and mortality. Increasing preload, or stressed venous volume is the therapeutic goal of fluid administration, which leads to a higher stroke volume and cardiac output. Objective: The purpose of this research was to see if there was a relationship between measurements of central venous pressure (CVP) and ultrasound measurements of the inferior vena cava collapsibility index(IVC CI), in the assessment of intravascular volume status in ventilated septic shock patients. Patients and Methods: : Following approval from the Al-Azhar University Ethical Committee, 60 patients aged 20 to 60 years old, both sex, who had been admitted to the ICU of Al-Azhar University hospitals with already inserted central venous catheter(CVC) for appropriate indication took part in a single blinded correlational study. Continuous monitoring of hemodynamic parameters was carried out. Ultrasound guided IVC CI was assessed when patients were lying down, then CVP measurements were taken. Signs of hypovolemia, such as tachycardia, hypotension, and acidosis, were assessed clinically. Results: In our study group, CVP and IVC-CI had a highly statistically significant negative correlation(p-value<0.001). Conclusion: In ventilated, crucially sick patients with septic shock, ultrasound guided measurements of IVC-CI can be utilized as a non-invasive, quick, and simple adjuvant procedure for assessing intravascular volume and guiding fluid responsiveness.