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Inferior Vena Cava Collapsibility Index Versus Passive Leg Raise To Assess Fluid Responsiveness in Non-Intubated Septic Patients - A Prospective Observational Study

Background: Rapid fluid loading at diagnosis of sepsis is part of standard treatment. Predictive tools of fluid responsiveness are required to guide fluid resuscitation. The Passive Leg Raise [PLR] manoeuvre can predict fluid responsiveness in non-intubated patients with sepsis. The Inferior Vena Cava Collapsibility Index [IVCCI] can also be utilised but is not routinely performed. Aim: To investigate the correlation between Inferior Vena Cava Collapsibility Index [IVCCI] and a Passive Leg Raise [PLR] manoeuvre for the assessment of fluid responsiveness in non-intubated septic patients in a tertiary referral hospital in Sub-Saharan Africa. Methodology: A prospective observational study which recruited non-intubated septic patients who were hypotensive [mean arterial pressure less than 65 mm Hg], requiring fluid resuscitation. Focused Cardiac Ultrasound [FoCUS] was used to measure IVCCI followed immediately by a PLR manoeuvre for comparison. Patients were classified as fluid responders if they had an IVCCI ≥ 50% and/or an increase of 10% in pulse pressure following a PLR. The correlation between IVCCI and PLR on each patient in predicting fluid responsiveness was then assessed. Results: 38 patients satisfied the inclusion criteria. McNemar’s test yielded a p=0.039 indicating that PLR test and IVCCI are not equivalent in predicting fluid responsiveness in non-intubated septic patients. A Cohen’s Kappa of 0.283 signified only a “fair” correlation between the two. An IVCCI cut-off of 30% would have resulted in a near- perfect agreement as evidenced by a Cohen’s Kappa value of 0.93. A cut off between 30-40% would give a Cohen’ Kappa of 0.81 with a strong level of agreement. Conclusion: The PLR test and IVCCI test have a fair correlation and are not identical in predicting fluid responsiveness in non-intubated spontaneously breathing septic patients.

Fluid Responsiveness, Passive Leg Raise Manoeuvre, Inferior Vena Cava Collapsibility Index, Focused Cardiac Ultrasound, Sepsis

APA Style

Anne-Marie Githaiga, Wangari Waweru-Siika, Mohamed Jeilan, Idris Chikophe, Vitalis Mung’ayi. (2023). Inferior Vena Cava Collapsibility Index Versus Passive Leg Raise To Assess Fluid Responsiveness in Non-Intubated Septic Patients - A Prospective Observational Study. International Journal of Anesthesia and Clinical Medicine, 11(2), 88-97. https://doi.org/10.11648/j.ijacm.20231102.17

ACS Style

Anne-Marie Githaiga; Wangari Waweru-Siika; Mohamed Jeilan; Idris Chikophe; Vitalis Mung’ayi. Inferior Vena Cava Collapsibility Index Versus Passive Leg Raise To Assess Fluid Responsiveness in Non-Intubated Septic Patients - A Prospective Observational Study. Int. J. Anesth. Clin. Med. 2023, 11(2), 88-97. doi: 10.11648/j.ijacm.20231102.17

AMA Style

Anne-Marie Githaiga, Wangari Waweru-Siika, Mohamed Jeilan, Idris Chikophe, Vitalis Mung’ayi. Inferior Vena Cava Collapsibility Index Versus Passive Leg Raise To Assess Fluid Responsiveness in Non-Intubated Septic Patients - A Prospective Observational Study. Int J Anesth Clin Med. 2023;11(2):88-97. doi: 10.11648/j.ijacm.20231102.17

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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