• Kemal Sener, Adem Cakir, Onder Yesiloglu, Ertugrul Altug, Ramazan Güven, and Mücahit Kapci.
• Department of Emergence Medicine, Republic of Turkey, Ministry of Healthy Başaksehir Çam and Sakura State Hospital, Istanbul, Turkey. drkemalsener@hotmail.com.
• Ir J Med Sci. 2024 Feb 1; 193 (1): 363368363-368.

BackgroundCases of intoxication are increasing day by day and these patients are presenting to emergency departments. These patients are usually individuals with poor self-care, inadequate oral intake, and unable to meet their own needs, and may have significant dehydration due to the agents they have taken. The caval index (CI) is a recently used index to determine fluid requirement and response.AimsWe aimed to evaluate the success of CI in determining and monitoring dehydration in intoxication patients.MethodsOur study was conducted prospectively in the emergency department of a single tertiary care center. A total of ninety patients were included in the study. Caval index was calculated by measuring inspiratory and expiratory inferior vena cava diameters. Caval index measurements were repeated after 2 and 4 h.ResultsPatients who were hospitalized, took multiple drugs, or needed inotropic agents had significantly higher caval index levels. A further increase in caval index levels was observed on second and third caval index evaluations in patients who received inotropic agents along with fluid resuscitation. Levels of systolic blood pressure recorded at admission (0. hour) showed a significant correlation with caval index and shock index. Caval index and the shock index were highly sensitive and specific at predicting mortality.ConclusionIn our study, we found that CI can be used as an index to assist emergency clinicians in determining and monitoring fluid requirement in cases of intoxication presenting to the emergency department.© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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