Prediction of Volume Responsiveness by Echocardiography in Comparative Study with Traditional Measurements in Septicemic Patients

Background: In septicemic cases, fluid therapy is typically the initial treatment for circulatory dysfunction.Aim: To find the best method for fluid challenge assessment by using static monitoring like pulse, blood pressure, urine output, Capillary refilling time and central venous pressure (CVP) or by dynamic monitoring like Echo (cardiac output (CO), stroke volume (SV), Evaluation of the Right Ventricle end-diastolic index, Inferior Vena Cava Collapsibility Index, left ventricular ejection fraction) and Passive leg rising test in septicemic patients receiving hemodynamic monitoring which is the main target for our paper.Patients and methods: This comparative prospective research conducted on 88 cases separated into Group A=44 patients and Group B=44 patients in Al-Azhar University Hospitals, for Boys in Cairo from June 2023 till December 2023.Results: Regarding all Static measurements in Group A before and after the fluid challenge, there was a highly statistically significant difference among the examined groups p=0.0001. Regarding Dynamic measurements in Group B before and after fluid challenge, there was no statistically significant difference regarding RVEDV Index, LVEDV Index, E/Ea., LVEF p= 0.2126, 0.3354, 0.2275, 0.254 respectively. While there was a highly statistically significant difference regarding Cardiac output, Stroke volume, and IVC collapsibility index p=0.0030, 0.0001, 0.0003.Conclusion: We concluded that mean arterial pressure enabled prediction of a positive response to fluid administration with 93.3%sensitivity and 100% specificity. Also, cardiac output enabled the prediction of a positive response to fluid administration with 100% sensitivity and 92.6% specificity.