1. Respiratory changes of the inferior vena cava diameter predict fluid responsiveness in spontaneously breathing patients with cardiac arrhythmias
- Author
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Fabienne Saulnier, Vincent Colas, Maeva Kyheng, Julien Poissy, Delphine Colling, Patrick Girardie, Raphael Favory, Perrine Bortolotti, Benoit Voisin, Sebastien Preau, Florent Dewavrin, Centre hospitalier [Valenciennes, Nord], Service de soins intensifs, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Lille Inflammation Research International Center - U 995 (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), This study was supported by the academic hospital of Lille., Université de Lille, LillOA, CHU Lille, Inserm, Université de Lille, Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille], Lille Inflammation Research International Center (LIRIC) - U995, Lille Inflammation Research International Center - U 995 [LIRIC], and Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
- Subjects
medicine.medical_specialty ,Population ,Hemodynamics ,Fluid responsiveness ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Inferior vena cava ,03 medical and health sciences ,0302 clinical medicine ,Echocardiography ,Ultrasound ,Sepsis ,Atrial fibrillation ,Arrhythmia ,Hemodynamic ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Internal medicine ,medicine ,cardiovascular diseases ,Respiratory system ,education ,education.field_of_study ,business.industry ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Exhalation ,Cardiac arrhythmia ,030208 emergency & critical care medicine ,lcsh:RC86-88.9 ,medicine.disease ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,medicine.vein ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Breathing ,Cardiology ,cardiovascular system ,business - Abstract
Comment in : Inferior vena cava variation predicts fluid responsiveness during dysrhythmias: a rational rearrangement of chairs on The Titanic. [Ann Transl Med. 2018]; International audience; BACKGROUND: Whether the respiratory changes of the inferior vena cava diameter during a deep standardized inspiration can reliably predict fluid responsiveness in spontaneously breathing patients with cardiac arrhythmia is unknown.METHODS: This prospective two-center study included nonventilated arrhythmic patients with infection-induced acute circulatory failure. Hemodynamic status was assessed at baseline and after a volume expansion of 500 mL 4% gelatin. The inferior vena cava diameters were measured with transthoracic echocardiography using the bi-dimensional mode on a subcostal long-axis view. Standardized respiratory cycles consisted of a deep inspiration with concomitant control of buccal pressures and passive exhalation. The collapsibility index of the inferior vena cava was calculated as [(expiratory-inspiratory)/expiratory] diameters.RESULTS: Among the 55 patients included in the study, 29 (53%) were responders to volume expansion. The areas under the ROC curve for the collapsibility index and inspiratory diameter of the inferior vena cava were both of 0.93 [95% CI 0.86; 1]. A collapsibility index ≥ 39% predicted fluid responsiveness with a sensitivity of 93% and a specificity of 88%. An inspiratory diameter
- Published
- 2018