• Dorota Sobczyk, Krzysztof Nycz, and Pawel Andruszkiewicz.
• Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland. Electronic address: dorotasobczyk@yahoo.com.
• J. Cardiothorac. Vasc. Anesth. 2015 Jan 1; 29 (3): 663-9.

ObjectiveTo assess validity of respiratory variation of inferior vena cava (IVC) diameter to predict fluid responsiveness and guide fluid therapy in mechanically ventilated patients during the first 6 hours after elective cardiac surgery.DesignProspective observational case series study.SettingSingle-center hospital.Patients50 consecutive patients undergoing elective cardiac surgery.InterventionsTransthoracic bedside echocardiography.Measurements And Main ResultsParameters derived from ultrasonographic assessment of the IVC diameter (collapsibility index [CI], distensibility index [DI], and IVC/aorta index). In the whole study group, change in fluid balance correlated with change in IVC maximum diameter (p = 0.034, r = 0.176). IVC-CI and IVC-DI correlated with IVC/aorta index. A weak correlation between central venous pressure (CVP) and IVC-derived parameters (IVC-CI and IVC-DI) was noticed. Despite statistical significance (p<0.05), all observed correlations expressed low statistical power (r<0.21). There were no statistically significant differences between fluid responders and nonresponders in relation to clinical parameters, CVP, ultrasound IVC measurement, and IVC-derived indices.ConclusionDynamic IVC-derived parameters (IVC-CI, IVC-DI, and IVC/aorta index) and CVP are not reliable predictors of fluid responsiveness in the first 6 hours after cardiac surgery. Complexity of physiologic factors modulating cardiac performance in this group may be responsible for the difficulty in finding a plausible monitoring tool for fluid guidance. Bedside ultrasonographic measurement of IVC is unable to predict fluid responsiveness in the first 6 hours after cardiac surgery.Copyright © 2015 Elsevier Inc. All rights reserved.

30 keywords...

hide…