FLUID RESPONSIVENESS PREDICTION IN MECHANICALLY VENTILATED HYPOTENSIVE PATIENTS: THE ROLE OF PULSE PRESSURE VARIATION AND INFERIOR VENA CAVA DISTENSIBILITY INDEX

Background: Patients in the critical care unit having acute circulatory insufciency generally benet from uid resuscitation and this forms the primary line of management. Studies have shown that more than fty percent of ICU patients will require uid resuscitation. These patients require vigilant monitoring of intravascular volume to guide uid resuscitation in order to prevent deleterious effects of excessive uid administration. Objective: Compare the predictive power of the Pulse Pressure Variation (PPV) and the distensibility index of the Inferior Vena Cava (dIVC) for predicting uid responsiveness in mechanically ventilated hypotensive patients. Patients and Methods: Study was conducted on forty-four hypotensive patients receiving mechanical ventilation requiring uid resuscitation. PPV and dIVC were recorded before and after uid administration. Fluid responders were identied when Cardiac output increased by ≥15%. Results: dIVC and PPV values showed a statistically signicant difference post uid resuscitation in both responders and non-responders group. The ROC curves which determined the dIVC had 100% sensitivity and 93.3% specicity at a threshold value greater than 42.96% with AUC=0.961 and was statistically signicant (p<0.001). PPV had a 96.6% sensitivity and 100% specicity at a threshold value greater than 24.5 with AUC=0.998 (p<0.001). Conclusion: The dIVC and PPV have similar predictive power in determining uid responsiveness in mechanically ventilated hypotensive patients. dIVC and PPV performed equally well in predicting uid responsiveness in these patients.