INFERIOR VENA CAVA COLLAPSIBILITY INDEX AS A NON-INVASIVE METHOD OF ASSESSING THE VOLEMIC STATUS OF PATIENTS DURING SPINE INTERVENTIONS

Authors

  • Mykhailo Ivachevskij SHEI «Uzhhorod National University». Ukraine, Ukraine
  • Andriy Rusyn SHEI «Uzhhorod National University». Ukraine, Ukraine
  • Vitalina Ivachevska SHEI «Uzhhorod National University». Ukraine, Ukraine

DOI:

https://doi.org/10.15674/0030-59872024133-37

Keywords:

Volemic status, collapsing index of the inferior vena cava, central venous pressure,

Abstract

Objective. To prove the possibility of using non-invasive diagnostics of the volemic state of postoperative patients using ultrasound assessment of inferior vena cava collapsibility index. Methods. The study included 67 patients who underwent transpedicular fixation of the spine with laminectomy. Volemiс status
was determined for all participants in two ways: by catheterization of the central vein and determination of central venous pressure, as well as by ultrasound examination of the inferior vena cava and calculation of inferior vena cava collapsibility index. Results. According to the results of the invasive assessment
of central venous pressure, patients were divided into 3 groups: group I (patients in hypovolemic state, n = 31), group II (patients in euvolemic state, n = 25) and group III (patients in hypervolemic state, n = 11 ). The average values of central venous pressure indicators in patients of these groups were statistically significantly different from each other (p < 0.01). The difference between the mean values of the inferior vena cava collapse index in the respective groups was statistically significant (p < 0.01). A reliable inverse correlation of very high strength was found between the indicators of inferior vena cava collapsibility index and central venous pressure (p < 0.05). Conclusions. Determination of the patient's volemic state is an extremely important tool for the correct selection of the fluid volume management. Ultrasound assessment of volemic status has a number of advantages, such as the non-invasiveness of the method, wide availability, low price and speed of execution. According to the results of our study, the possibility of using inferior vena cava collapsibility index to assess the volemic status of patients has been demonstrated.

Author Biographies

Mykhailo Ivachevskij, SHEI «Uzhhorod National University». Ukraine

MD, Prof.

Andriy Rusyn, SHEI «Uzhhorod National University». Ukraine

MD, Prof.

Vitalina Ivachevska, SHEI «Uzhhorod National University». Ukraine

MD, PhD

 

References

  1. Boyd, J. H., Forbes, J., Nakada, T.-A., Walley, K. R., & Russell, J. A. (2011). Fluid resuscitation in septic shock: A positive fluid balance and elevated central venous pressure are associated with increased mortality*. Critical Care Medicine, 39(2), 259–265. https://doi.org/10.1097/ccm.0b013e3181feeb15
  2. Kaptein, M. J., & Kaptein, E. M. (2017). Focused Real-Time Ultrasonography for Nephrologists. International Journal of Nephrology, 2017, 1–13. https://doi.org/10.1155/2017/3756857
  3. Kastrup, M., Markewitz, A., Spies, C., Carl, M., Erb, J., Große, J., & Schirmer, U. (2007). Current practice of hemodynamic monitoring and vasopressor and inotropic therapy in post-operative cardiac surgery patients in Germany: results from a postal survey. Acta Anaesthesiologica Scandinavica, 51(3), 347–358. https://doi.org/10.1111/j.1399-6576.2006.01190.x
  4. Stawicki, S. P., Braslow, B. M., Panebianco, N. L., Kirkpatrick, J. N., Gracias, V. H., Hayden, G. E., & Dean, A. J. (2009). Intensivist Use of Hand-Carried Ultrasonography to Measure IVC Collapsibility in Estimating Intravascular Volume Status: Correlations with CVP. Journal of the American College of Surgeons, 209(1), 55–61. https://doi.org/10.1016/j.jamcollsurg.2009.02.062
  5. Eisen, L. A., Narasimhan, M., Berger, J. S., Mayo, P. H., Rosen, M. J., & Schneider, R. F. (2006). Mechanical Complications of Central Venous Catheters. Journal
  6. of Intensive Care Medicine, 21(1), 40–46. https://doi.org/10.1177/0885066605280884
  7. Marik, P. E., Baram, M., & Vahid, B. (2008). Does Central Venous Pressure Predict Fluid Responsiveness?*: A Systematic Review of the Literature and the Tale of Seven
  8. Mares. Chest, 134(1), 172–178. https://doi.org/10.1378/chest.07-2331
  9. Natori, H., Tamaki, S., & Kira, S. (1979). Ultrasonographic evaluation of ventilatory effect on inferior vena caval configuration. Am Rev Respir Dis., 120(2), 421–427.
  10. Lyon, M., Blaivas, M., & Brannam, L. (2005). Sonographic measurement of the inferior vena cava as a marker of blood loss. The American Journal of Emergency Medicine, 23(1), 45–50. https://doi.org/10.1016/j.ajem.2004.01.004
  11. Bortolotti, P., Colling, D., Colas, V., Voisin, B., Dewavrin, F., Poissy, J., Girardie, P., Kyheng, M., Saulnier, F., Favory, R., & Preau, S. (2018). Respiratory changes
  12. of the inferior vena cava diameter predict fluid responsiveness in spontaneously breathing patients with cardiac arrhythmias. Annals of Intensive Care, 8(1). https://doi.org/10.1186/s13613-018-0427-1
  13. Caplan, M., Durand, A., Bortolotti, P., Colling, D., Goutay, J., Duburcq, T., Drumez, E., Rouze, A., Nseir, S., Howsam, M., Onimus, T., Favory, R., & Preau, S. (2020). Measurement site of inferior vena cava diameter affects the accuracy with which fluid responsiveness can be predicted in spontaneously breathing patients: a post hoc analysis of two prospective cohorts. Annals of Intensive Care, 10(1), 168. https://doi.org/10.1186/s13613-020-00786-1
  14. Cecconi, M., Hofer, C., Teboul, J.-L., Pettila, V., Wilkman, E., Molnar, Z., Della Rocca, G., Aldecoa, C., Artigas, A., Jog, S., Sander, M., Spies, C., Lefrant, J.-Y., & De Backer, D. (2015). Fluid challenges in intensive care: the FENICE study. Intensive Care Medicine, 41(9), 1529–1537. https://doi.org/10.1007/s00134-015-3850-x
  15. Kircher, B. J., Himelman, R. B., & Schiller, N. B. (1990). Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. The American Journal of Cardiology, 66(4), 493–496. https://doi.org/10.1016/0002-9149(90)90711-9
  16. Nagdev, A. D., Merchant, R. C., Tirado-Gonzalez, A., Sisson, C. A., & Murphy, M. C. (2010). Emergency Department Bedside Ultrasonographic Measurement of the Caval Index for Noninvasive Determination of Low Central Venous Pressure. Annals of Emergency Medicine, 55(3), 290–295. https://doi.org/10.1016/j.annemergmed.2009.04.021
  17. Broyles, M. G., Subramanyam, S., Barker, A. B., & Tolwani, A. J. (2021). Fluid repon- siveness in the critically ill patient. Adv Chronic Kidney Dis, 28, 20–8. https://doi.
  18. org/10.1053/j.ackd.2021.06.006
  19. Pourmand, A., Pyle, M., Yamane, D., Sumon, K., & Frasure, S. E. (2019). The utility of point-of-care ultrasound in the assessment of volume status in acute and critically ill patients. World Journal of Emergency Medicine, 10(4), 232. https://doi.org/10.5847/wjem.j.1920-8642.2019.04.007
  20. Kaptein, M. J., & Kaptein, E. M. (2021). Inferior Vena Cava Collapsibility Index: Clinical Validation and Application for
  21. Assessment of Relative Intravascular Volume. Advances in Chronic Kidney Disease, 28(3), 218–226. https://doi.org/10.1053/j.ackd.2021.02.003
  22. Broyles, M. G., Subramanyam, S., Barker, A. B., & Tolwani, A. J. (2021). Fluid Responsiveness in the Critically Ill Patient. Advances in Chronic Kidney Disease, 28(1), 20–28. https://doi.org/10.1053/j.ackd.2021.06.006
  23. Long, E., Oakley, E., Duke, T., & Babl, F. E. (2017). Does Respiratory Variation in Inferior Vena Cava Diameter Predict Fluid Responsiveness. Shock, 47(5), 550–559. https://doi.org/10.1097/shk.0000000000000801
  24. Lanspa, M. J., Grissom, C. K., Hirshberg, E. L., Jones, J. P., & Brown, S. M. (2013). Applying Dynamic Par

How to Cite

Ivachevskij, M. ., Rusyn, A. ., & Ivachevska, V. . (2024). INFERIOR VENA CAVA COLLAPSIBILITY INDEX AS A NON-INVASIVE METHOD OF ASSESSING THE VOLEMIC STATUS OF PATIENTS DURING SPINE INTERVENTIONS. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (1), 33–37. https://doi.org/10.15674/0030-59872024133-37

Issue

Section

ORIGINAL ARTICLES