Diagnostic, therapeutic and prognostic value of the inferior vena cava collapsibility index in hemodynamically unstable septic children and adults in resource limited intensve care settings.

Fluid resuscitation remains a cornerstone in the manage- ment of septic shock, yet achieving the right balance be- tween under- and over-resuscitation is especially chal- lenging in resource-limited intensive care settings. The inferior vena cava collapsibility index (IVCCI), derived from respiratory variations in the inferior vena cava di- ameter, has emerged as a simple, noninvasive, and repro- ducible bedside tool for assessing intravascular volume status. Evidence from both adult and pediatric studies highlights its diagnostic and prognostic relevance, show- ing correlations with central venous pressure, cardiac output variations, and sepsis-related mortality. However, factors such as mechanical ventilation, intra-abdominal pressure, and operator skill can influence its accuracy. Recent research, particularly in pediatric and neonatal populations, supports its use in predicting fluid respon- siveness and guiding resuscitation even under con- strained technical conditions. In resource-limited ICUs, IVCCI provides a helpful strategy for individualized fluid management in sepsis, potentially improving outcomes while minimizing complications associated with fluid overload. Sandardization of measurement protocols and focused training in point-of-care ultrasound are essential to fully integrate IVCCI monitoring into routine critical care practice.