Assessment of fluid responsiveness using inferior vena cava collapsibility index in hypovolemic patients using ultrasound in the emergency department

 

Abstract              Assessment of hemodynamic status in a shock state remains a challenging issue in emergency medicine. Ultrasound has expanded to become a rapid, bed-side and non-invasive method for the assessment of patient physiology. The primary utility of bedside ultrasound is to measure the diameter of inferior vena cava for assessment of the intravascular volume status of the patient. This may be of utility in cases of undifferentiated hypotension or other scenarios of abnormal volume states, such as sepsis, dehydration, haemorrhage, trauma or heart failure. changes in volume status will be reflected in sonographic evaluation of the inferior vena cava, where increased or decreased collapsibility of the vessel will help guide clinical management of the patient. The combination of the absolute diameter of the inferior vena cava and the degree of collapse with respiration may give an estimate of central venous pressure and substitute for more invasive measurements. Early recognition and appropriate treatment of shock have been shown to decrease mortality. Incorporation of bedside ultrasound in patients with undifferentiated shock allows for rapid evaluation of reversible causes of shock and improves accurate diagnosis in undifferentiated hypotension

Key word: inferior vena cava collapsibility index.