Assessment of volume status in ventilated shocked patients by ultrasound guided Inferior Vena Cava Distensibility Index and Central Venous Pressure ,(Comparative Clinical study).

Background: fluid therapy remains the cornerstone of hemodynamic resuscitation of shocked patients. Inappropriate fluid administration is associated with increased mortality and the length of stay. The most commonly used parameter for detecting volume status was central venous pressure (CVP); however, recently, various methods are being used for volume assessment like inferior vena cava distensibility index (IVC DI).
Objective: This study aimed to evaluate the relationship between CVP and ultrasound guided IVC -DI as a tool to assess the volume status and fluid responsiveness in ventilated shocked patients as regard sensitivity and accuracy.
Methods: Fifty shocked patients were prospectively included in the study. patients were mechanically ventilated , IVC DI measurement was evaluated using ultrasonography and simultaneous CVP values were recorded .
Results: IVC DI has higher accuracy in predicting hypovolemia in ventilated shocked patients than CVP . Cutoff point 14.5% IVC DI% has sensitivity 94% and specificity 100% for predicting hypovolemia while cutoff point 7cmH2O CVP has sensitivity 96% and specificity 95.4% . IVC-DI has higher accuracy in predicting fluid responsiveness , cutoff point 13% IVC DI has sensitivity of 100% and specificity 93.3% for predicting fluid responsiveness while cutoff point 7 cmH2O CVP has sensitivity 85.2% and specificity of 95.3%.
Conclusion: CVP and ultrasound guided IVC-DI are reliable markers in predicting fluid responsiveness and hypovolemia among ventilated shocked patients with the superiority of IVC-DI.