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387969

The use of end-expiratory occlusion test . inferior vena cava respiratory variation for the prediction of volume responsiveness in mechanically ventilated patients with sepsis: A

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Last updated: 31 Dec 2024

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Abstract

Sepsis being a chief prominent fatal condition in critically ill patients. In septic-shocked patients, the first-line therapeutic intervention is fluid resuscitation in an attempt to improve their cardiac output (COP). However, fluids must be given only if the chance of improving COP exists. So, assessing fluid responsiveness is crucial. To our knowledge, yet no studies comparing the end-expiratory occlusion (EEO) test and the variation of the inferior vena cava (IVC) diameter with respiration (ΔIVC) in hypovolemic cases. So, our aim is to use both tests as indices for responsiveness to fluid in septic mechanically ventilated (MV) patients. The Patients and Method: Thirty-four MV septic patients were enrolled and baseline COP assessment was performed followed by an EEO test applied to each patient, after which, COP was measured to detect the probable responders (defined as an increased COP by ≥ 15%) and non-responders. Then, ΔIVC was assessed for the same patients to predict the probable responders (with ΔIVC >12%) and non-responders. Finally, fluid therapy was initiated as per the guidelines of surviving sepsis campaign (2021) followed by COP re-assessment to determine actual fluid responders\non-responders. Results: 67% of the cases was responding to fluid. Receiver operating characteristic showed areas under curve for EEO and ΔIVC in predicting responsiveness to fluid were 0.597 and 0.925, respectively. EEO (32.4%) was predictive with 47.8% sensitivity and 100% specificity. The ΔIVC (64.7%) was predictive with 91.3% sensitivity and 100% specificity. Conclusion: IVC-respiratory variation showed better values in prediction of response to fluid in MV patients with sepsis than EEO test.

DOI

TEJA-2023-0133

Keywords

IVC, EEO, fluid responsiveness, ventilated, Sepsis

Authors

First Name

Nevein

Last Name

Fawzy El Sayed Abdelmaksoud

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Orcid

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First Name

Gamal Eldin Mohammad

Last Name

Ahmad Elewa

MiddleName

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Orcid

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First Name

Mayar Hassan Sayed Ahmed

Last Name

El Sersi

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First Name

Dalia Fahmy Emam Ali

Last Name

Nawar

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Orcid

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First Name

Ahmed Monier Ahmed Youssef

Last Name

Eldemerdash

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Orcid

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Volume

39

Article Issue

1

Related Issue

51163

Issue Date

2023-12-01

Receive Date

2023-05-25

Publish Date

2023-12-31

Page Start

755

Page End

762

Print ISSN

1110-1849

Online ISSN

1687-1804

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https://egja.journals.ekb.eg/article_387969.html

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https://egja.journals.ekb.eg/service?article_code=387969

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387,969

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Publication Title

Egyptian Journal of Anaesthesia

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https://egja.journals.ekb.eg/

MainTitle

The use of end-expiratory occlusion test . inferior vena cava respiratory variation for the prediction of volume responsiveness in mechanically ventilated patients with sepsis: A comparative study

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Article

Created At

21 Dec 2024