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Volume 4, Issue 2
  • ISSN: 0250-6882
  • E-ISSN: 0250-6882
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Abstract

Background and Objective

Volume replacement remains the cornerstone of resuscitation in critically ill patients. This study explored the ability of the subclavian vein collapsibility index to predict fluid responsiveness.

Methods

In this prospective observational study conducted in the Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, sonographic evaluation of inferior vena cava and the right subclavian vein was carried out at three time points for hypotensive patients admitted to the emergency department. The study population was divided into two groups: responders and non-responders, based on a ≥ 15% increase in stroke volume following fluid bolus.

Results

Among 45 recruited patients, 33 patients were responders. The area under the ROC curve for SCV CI at baseline to predict fluid responsiveness was 0.745 (95% confidence interval: 0.549 – 0.941; p = 0.014). An SCV-CI of 46% predicted fluid responsiveness in a hypotensive patient in terms of change in stroke volume by 15% following fluid bolus with a sensitivity of 87.88% (95% confidence interval: 71.80% to 96.60%) and specificity of 66.67% (95% confidence interval: 34.89% to 90.08%). Spearman’s correlation coefficient between IVC CI and SCV CI was 0.59 (p < 0.001, n = 135).

Conclusion

The results of the study demonstrated that right subclavian vein respiratory variation has the ability to predict fluid responsiveness in a spontaneously breathing patient in circulatory shock and correlates with the inferior vena cava collapsibility index. The subclavian vein can be an alternative to the inferior vena cava in predicting fluid responsiveness in spontaneously breathing patients.

© 2023 Bentham Science Publishers
© 2023 The Author(s). Published by Bentham Science Publisher. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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/content/journals/nemj/10.2174/04666230328094312
2023-06-13
2025-06-17

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References

  1. MichardF. TeboulJ.L. Predicting fluid responsiveness in ICU patients: A critical analysis of the evidence.Chest200212162000200810.1378/chest.121.6.200012065368
     [Google Scholar]
  2. MarikP.E. MonnetX. TeboulJ.L. Hemodynamic parameters to guide fluid therapy.Ann. Intensive Care2011111910.1186/2110‑5820‑1‑121906322
     [Google Scholar]
  3. BoydJ.H. ForbesJ. NakadaT. WalleyK.R. RussellJ.A. Fluid resuscitation in septic shock: A positive fluid balance and elevated central venous pressure are associated with increased mortality.Crit. Care Med.201139225926510.1097/CCM.0b013e3181feeb1520975548
     [Google Scholar]
  4. YildirimturkO. TayyareciY. ErdimR. OzenE. YurdakulS. AytekinV. DemirogluI.C.C. AytekinS. Assessment of right atrial pressure using echocardiography and correlation with catheterization.J. Clin. Ultrasound201139633734310.1002/jcu.2083721544830
     [Google Scholar]
  5. IbertiT.J. BenjaminE. GruppiL. RaskinJ.M. Ventricular arrhythmias during pulmonary artery catheterization in the intensive care unit prospective study.Am. J. Med.198578345145410.1016/0002‑9343(85)90337‑73976703
     [Google Scholar]
  6. EvansD.C. DoraiswamyV.A. ProsciakM.P. SilvieraM. SeamonM.J. FunesV.R. CipollaJ. WangC.F. KavuturuS. TorigianD.A. CookC.H. LindseyD.E. SteinbergS.M. StawickiS.P. Complications associated with pulmonary artery catheters: A comprehensive clinical review.Scand. J. Surg.200998419920810.1177/14574969090980040220218415
     [Google Scholar]
  7. NagiAI ShafikAM FatahAMA SelimaWZ HefnyAF Inferior vena cava collapsibility index as a predictor of fluid responsiveness in sepsis-related acute circulatory failure.Ain-Shams J Anesthesiol202113(1).10.1186/s42077‑021‑00194‑y
     [Google Scholar]
  8. LevitovA. FrankelH.L. BlaivasM. KirkpatrickA.W. SuE. EvansD. SummerfieldD.T. SlonimA. BreitkreutzR. PriceS. McLaughlinM. MarikP.E. ElbarbaryM. Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients - Part II: Cardiac ultrasonography.Crit. Care Med.20164461206122710.1097/CCM.000000000000184727182849
     [Google Scholar]
  9. DasS.K. ChoupooN.S. PradhanD. SaikiaP. MonnetX. Diagnostic accuracy of inferior vena caval respiratory variation in detecting fluid unresponsiveness.Eur. J. Anaesthesiol.2018351183183910.1097/EJA.000000000000084129901465
     [Google Scholar]
  10. OrsoD. PaoliI. PianiT. CilentiF.L. CristianiL. GuglielmoN. Accuracy of ultrasonographic measurements of inferior vena cava to determine fluid responsiveness: A systematic review and meta-analysis.J. Intensive Care Med.202035435436310.1177/088506661775230829343170
     [Google Scholar]
  11. KimuraB.J. DalugduganR. GilcreaseG.W.III PhanJ.N. ShowalterB.K. WolfsonT. The effect of breathing manner on inferior vena caval diameter.Eur. J. Echocardiogr.201112212012310.1093/ejechocard/jeq15720980326
     [Google Scholar]
  12. MullerL. BobbiaX. ToumiM. LouartG. MolinariN. RagonnetB. QuintardH. LeoneM. ZoricL. LefrantJ. AzuRea group Respiratory variations of inferior vena cava diameter to predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure: Need for a cautious use.Crit. Care2012165R18810.1186/cc1167223043910
     [Google Scholar]
  13. DiptiA. SoucyZ. SuranaA. ChandraS. Role of inferior vena cava diameter in assessment of volume status: A meta-analysis.Am. J. Emerg. Med.201230814141419.e110.1016/j.ajem.2011.10.01722221934
     [Google Scholar]
  14. CorlK.A. GeorgeN.R. RomanoffJ. LevinsonA.T. ChhengD.B. MerchantR.C. LevyM.M. NapoliA.M. Inferior vena cava collapsibility detects fluid responsiveness among spontaneously breathing critically-ill patients.J. Crit. Care20174113013710.1016/j.jcrc.2017.05.00828525778
     [Google Scholar]
  15. CorlK. NapoliA.M. GardinerF. Bedside sonographic measurement of the inferior vena cava caval index is a poor predictor of fluid responsiveness in emergency department patients.Emerg. Med. Australas.201224553453910.1111/j.1742‑6723.2012.01596.x23039295
     [Google Scholar]
  16. AirapetianN. MaizelJ. AlyamaniO. MahjoubY. LorneE. LevrardM. AmmenoucheN. SeydiA. TinturierF. LobjoieE. DupontH. SlamaM. Does inferior vena cava respiratory variability predict fluid responsiveness in spontaneously breathing patients?Crit. Care201519140010.1186/s13054‑015‑1100‑926563768
     [Google Scholar]
  17. KentA. BahnerD.P. BoulgerC.T. EifermanD.S. AdkinsE.J. EvansD.C. SpringerA.N. BalakrishnanJ.M. ValiyaveedanS. GalwankarS.C. NjokuC. LindseyD.E. YeagerS. RoelantG.J. StawickiS.P.A. Sonographic evaluation of intravascular volume status in the surgical intensive care unit: A prospective comparison of subclavian vein and inferior vena cava collapsibility index.J. Surg. Res.2013184156156610.1016/j.jss.2013.05.04023764308
     [Google Scholar]
  18. KentA. PatilP. DavilaV. BaileyJ.K. JonesC. EvansD.C. BoulgerC.T. AdkinsE. BalakrishnanJ.M. ValiyaveedanS. GalwankarS.C. BahnerD.P. StawickiS.P. Sonographic evaluation of intravascular volume status: Can internal jugular or femoral vein collapsibility be used in the absence of IVC visualization?Ann. Thorac. Med.2015101444925593607
     [Google Scholar]
  19. WallaceD.J. AllisonM. StoneM.B. Inferior vena cava percentage collapse during respiration is affected by the sampling location: An ultrasound study in healthy volunteers.Acad. Emerg. Med.2010171969910.1111/j.1553‑2712.2009.00627.x20003120
     [Google Scholar]
  20. ZhuP. ZhangX. LuanH. FengJ. CuiJ. WuY. ZhaoZ. Ultrasonographic measurement of the subclavian vein diameter for assessment of intravascular volume status in patients undergoing gastrointestinal surgery: Comparison with central venous pressure.J. Surg. Res.2015196110210610.1016/j.jss.2015.02.06325818975
     [Google Scholar]
  21. GiraudR. AbrahamP.S. BrindelP. SiegenthalerN. BendjelidK. Respiratory changes in subclavian vein diameters predicts fluid responsiveness in intensive care patients: A pilot study.J. Clin. Monit. Comput.20183261049105510.1007/s10877‑018‑0103‑x29380189
     [Google Scholar]
  22. LongE. OakleyE. DukeT. BablF.E. Does respiratory variation in inferior vena cava diameter predict fluid responsiveness.Shock201747555055910.1097/SHK.000000000000080128410544
     [Google Scholar]
  23. ZhangZ. LuB. ShengX. JinN. Accuracy of stroke volume variation in predicting fluid responsiveness: A systematic review and meta-analysis.J. Anesth.201125690491610.1007/s00540‑011‑1217‑121892779
     [Google Scholar]
  24. SchoberP. BoerC. SchwarteL.A. Correlation coefficients: Appropriate use and interpretation.Anesthesia & Analgesia201812651763176810.1213/ANE.0000000000002864
     [Google Scholar]
/content/journals/nemj/10.2174/04666230328094312
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Subclavian Vein Collapsibility as a Predictor of Fluid Responsiveness in Spontaneously Breathing Hypotensive Patients
NEW Emirates Medical J 4, e280323215035 (2023); https://doi.org/10.2174/04666230328094312
/content/journals/nemj/10.2174/04666230328094312
/content/journals/nemj/10.2174/04666230328094312
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  • Article Type:     Research Article
Keyword(s): Circulatory shock; Fluid responsiveness; Spontaneous breathing; Subclavian vein; Vena Cava

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