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Prediction of post-induction hypotension in young adults using ultrasound-derived inferior vena cava parameters: An observational study

BACKGROUND AND AIMS: Inferior vena cava (IVC) diameter and its respiratory variability have been shown to predict post-induction hypotension with high specificity in a mixed population of patients. We assessed whether these parameters could be as reliable in healthy adult patients as in a mixed pati...

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Autores principales: Mohammed, Sadik, Syal, Rashmi, Bhatia, Pradeep, Chhabra, Swati, Chouhan, Ravindra S, Kamal, Manoj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8607854/
https://www.ncbi.nlm.nih.gov/pubmed/34898699
http://dx.doi.org/10.4103/ija.IJA_1514_20
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author Mohammed, Sadik
Syal, Rashmi
Bhatia, Pradeep
Chhabra, Swati
Chouhan, Ravindra S
Kamal, Manoj
author_facet Mohammed, Sadik
Syal, Rashmi
Bhatia, Pradeep
Chhabra, Swati
Chouhan, Ravindra S
Kamal, Manoj
author_sort Mohammed, Sadik
collection PubMed
description BACKGROUND AND AIMS: Inferior vena cava (IVC) diameter and its respiratory variability have been shown to predict post-induction hypotension with high specificity in a mixed population of patients. We assessed whether these parameters could be as reliable in healthy adult patients as in a mixed patient population. METHODS: In the present prospective observational study, 110 patients of either sex, aged between 18 and 50 years, belonging to American Society of Anesthesiologists class I and II, fasted as per the institutional protocol and scheduled for elective surgery under general anaesthesia were enroled. Prior to induction, ultrasound examination of IVC was done and variation in IVC diameter with respiration was assessed. Maximum and minimum IVC diameters [(dIVC(max)) and (dIVC(min)), respectively] over a single respiratory cycle were measured and collapsibility index (CI) was calculated. Vitals were recorded just before induction and at every minute after induction for 10 min. Episodes of hypotension (mean arterial pressure [MAP] <65 mmHg or fall in MAP >30% from baseline) during the observation period were recorded. The receiver operating characteristic (ROC) curve was constructed for determining optimum cut-off with sensitivity and specificity of IVC diameters and CI for development of hypotension. RESULTS: IVC was not visualised in 22 patients. Out of the remaining 88 patients, 17 (19.3%) patients developed hypotension after induction. The dIVC(max), dIVC(min) and CI were comparable between patients who developed and who did not develop hypotension. The area under curve of ROC for CI, dIVC(max) and dIVC(min) was 0.51, 0.55 and 0.52, respectively, with optimum cut-off value of 0.46, 1.42 and 0.73, respectively. CONCLUSION: Ultrasound-derived IVC parameters demonstrate poor diagnostic accuracy for prediction of hypotension after induction in healthy adult patients.
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spelling pubmed-86078542021-12-09 Prediction of post-induction hypotension in young adults using ultrasound-derived inferior vena cava parameters: An observational study Mohammed, Sadik Syal, Rashmi Bhatia, Pradeep Chhabra, Swati Chouhan, Ravindra S Kamal, Manoj Indian J Anaesth Original Article BACKGROUND AND AIMS: Inferior vena cava (IVC) diameter and its respiratory variability have been shown to predict post-induction hypotension with high specificity in a mixed population of patients. We assessed whether these parameters could be as reliable in healthy adult patients as in a mixed patient population. METHODS: In the present prospective observational study, 110 patients of either sex, aged between 18 and 50 years, belonging to American Society of Anesthesiologists class I and II, fasted as per the institutional protocol and scheduled for elective surgery under general anaesthesia were enroled. Prior to induction, ultrasound examination of IVC was done and variation in IVC diameter with respiration was assessed. Maximum and minimum IVC diameters [(dIVC(max)) and (dIVC(min)), respectively] over a single respiratory cycle were measured and collapsibility index (CI) was calculated. Vitals were recorded just before induction and at every minute after induction for 10 min. Episodes of hypotension (mean arterial pressure [MAP] <65 mmHg or fall in MAP >30% from baseline) during the observation period were recorded. The receiver operating characteristic (ROC) curve was constructed for determining optimum cut-off with sensitivity and specificity of IVC diameters and CI for development of hypotension. RESULTS: IVC was not visualised in 22 patients. Out of the remaining 88 patients, 17 (19.3%) patients developed hypotension after induction. The dIVC(max), dIVC(min) and CI were comparable between patients who developed and who did not develop hypotension. The area under curve of ROC for CI, dIVC(max) and dIVC(min) was 0.51, 0.55 and 0.52, respectively, with optimum cut-off value of 0.46, 1.42 and 0.73, respectively. CONCLUSION: Ultrasound-derived IVC parameters demonstrate poor diagnostic accuracy for prediction of hypotension after induction in healthy adult patients. Wolters Kluwer - Medknow 2021-10 2021-10-29 /pmc/articles/PMC8607854/ /pubmed/34898699 http://dx.doi.org/10.4103/ija.IJA_1514_20 Text en Copyright: © 2021 Indian Journal of Anaesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Mohammed, Sadik
Syal, Rashmi
Bhatia, Pradeep
Chhabra, Swati
Chouhan, Ravindra S
Kamal, Manoj
Prediction of post-induction hypotension in young adults using ultrasound-derived inferior vena cava parameters: An observational study
title Prediction of post-induction hypotension in young adults using ultrasound-derived inferior vena cava parameters: An observational study
title_full Prediction of post-induction hypotension in young adults using ultrasound-derived inferior vena cava parameters: An observational study
title_fullStr Prediction of post-induction hypotension in young adults using ultrasound-derived inferior vena cava parameters: An observational study
title_full_unstemmed Prediction of post-induction hypotension in young adults using ultrasound-derived inferior vena cava parameters: An observational study
title_short Prediction of post-induction hypotension in young adults using ultrasound-derived inferior vena cava parameters: An observational study
title_sort prediction of post-induction hypotension in young adults using ultrasound-derived inferior vena cava parameters: an observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8607854/
https://www.ncbi.nlm.nih.gov/pubmed/34898699
http://dx.doi.org/10.4103/ija.IJA_1514_20
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