Ventilated patients
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Feissel et al.(2424 Feissel M, Michard F, Faller JP, Teboul JL. The respiratory variation in inferior vena cava diameter as a guide to fluid therapy. Intensive Care Med. 2004;30(9):1834-7.)
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23 |
M, septic shock, TV 8 - 10mL/kg |
Hypoxemia with risk of death, right ventricular failure
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Δ ≥ 15% CO after fluids (8mL/kg hydroxyethylamide 6% for 20 minutes) |
ΔdVCI > 12% |
NPV 92%, PPV 93% |
Barbier et al.(2525 Barbier C, Loubières Y, Schmit C, Hayon J, Ricôme JL, Jardin F, et al. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30(9):1740-6.)
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39 |
MC, septic shock, TV 8.5mL/kg |
Impossible to perform EchoTT |
Δ ≥ 15% CI after fluids (7mL/kg of modified fluid gelatin 4% for 30 minutes) |
ΔdVCI > 18% |
S and E 90% (ASC 0,91; 0,84 - 0,98) |
Charbonneau et al.(3030 Charbonneau H, Riu B, Faron M, Mari A, Kurrek MM, Ruiz J, et al. Predicting preload responsiveness using simultaneous recordings of inferior and superior vena cavae diameters. Crit Care. 2014;18(5):473.)
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44 |
MC, septic shock, TV 8 -10mL/kg |
Hypoxemia with risk of death, right ventricular failure, respiratory effort, arrhythmia, impossible to perform EchoTT |
Δ ≥ 15% CI after fluids (7mL/kg of hydroxyethylamide 6% in 15 minutes) |
ΔdVCI > 21% |
S 38%, E 61% (AUC 0.43; 0.25 - 0.61) |
Theerawit et al.(3131 Theerawit P, Morasert T, Sutherasan Y. Inferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis. J Crit Care. 2016;36:246-51.)
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29 |
M, septic shock, TV 8mL/kg |
Arrhythmia, ascites, severe valvulopathy or intracardiac shunt, contraindication to sedatives/anesthetics |
Δ ≥ 15% CO after fluids (1 L 0.9% NaCl for 1 hour or 0.5L hydroxyethylamide 130/0.46% or 5% human albumin for 30 minutes) |
ΔdVCI > 10% |
S 75%, E 77% (AUC 0.69; 0.48 - 0.9) |
Vignon et al.(3232 Vignon P, Repessé X, Bégot E, Léger J, Jacob C, Bouferrache K, et al. Comparison of echocardiographic indices used to predict fluid responsiveness in ventilated patients. Am J Respir Crit Care Med. 2017;195(8):1022-32.)
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540 |
MC, shock of any cause, TV < 8mL/kg in 66% |
Pregnancy, amputation, or severe ischemia in lower limbs, contraindication for TEE or LLEM
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Δ ≥ 10% LVOT-VTI 1 minute after LLEM |
ΔdVCI ≥ 8% |
S 55%, E 70% (AUC 0.64) |
Nonventilated patients
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Airapetian et al.(99 Airapetian N, Maizel J, Alyamani O, Mahjoub Y, Lorne E, Levrard M, et al. Does inferior vena cava respiratory variability predict fluid responsiveness in spontaneously breathing patients? Crit Care. 2015;19:400.)
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59 |
MC, shock of any cause |
Signs of bleeding, arrhythmia, compression stockings, contraindication to LLEM, immediate need of volume |
Δ ≥ 10% CO after 0.5L of saline solution for 15 minutes |
ΔcVCI > 42% |
S 31%, E 97% NPV 59%, PPV 90% (ASC 0,62; 0,49 - 0,74) |
Muller et al.(2727 Muller L, Bobbia X, Toumi M, Louart G, Molinari N, Ragonnet B, Quintard H, Leone M, Zoric L, Lefrant JY; 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 Care. 2012;16(5):R188.)
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40 |
UN, septic, hemorrhagic, hypovolemic shock |
Pulmonary edema, right ventricular failure or high RA pressure
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Δ ≥ 15% LVOT-VTI after 0.5L hydroxyethylamide 130/0.46% for 15 minutes |
ΔcVCI > 40% |
S 70%, E 80% (ASC 0,77; 0,60 - 0,88) |