The Validity of Velocity Time Integral of Left Ventricular Outflow tract and Inferior Vena Cava Collapsibility Index Compared with Central Venous Pressure in Identifying the Fluid Responders in Shocked Patients

Background: Fluid responsiveness is a challenge in management of critically ill patients to avoid volume overload and hemodynamics instability. Various methods can be used but their applicability & accuracy vary. Aim of study: To determine the correlation between CVP, IVC CI, and VTI of LVOT measured by echocardiography in fluid assessment in shocked patients. Patients and methods: This study included 80 shocked patients (septic, hypovolemic, or anaphylactic shock). Measurements of CVP, IVC-CI, and VTI LVOT at 0,6,12,24 hours of admission were done. Result: There was a significant reduction in heart rate with P-value (P<0.001) at 6,12, and 24 hr, while there was a significant increase of mean arterial blood pressure and central venous pressure (CVP) after 12 hours and 24hrs with p-value (p=0.001) combined with a highly statistically significant increase of VTI of LVOT after 12hrs and 24hrs compared to baseline. At the same time, there was a statistically significant decrease in the IVC collapsibility index (%) after 12 hours. And 24 hours compared to baseline, with a p-value (p<0.05). So, while mean CVP increases, mean VTI LVOT increases, but mean IVC CI declines. Conclusion: VTI LVOT was the most significant predictor, followed by the IVC collapsibility index in the assessment of fluid responsiveness in shocked patients.