eISSN: 1731-2531
ISSN: 1642-5758
Anaesthesiology Intensive Therapy
Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Reviewers Abstracting and indexing Subscription Contact Instructions for authors Publication charge Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
3/2024
vol. 56
 
Share:
Share:
abstract:
Review article

Superior vena cava collapsibility index as a predictor of fluid responsiveness: a systematic review with meta-analysis

Tomasz Królicki
1
,
Maciej Molsa
1
,
Andrzej Tukiendorf
2
,
Ryszard Gawda
1
,
Tomasz Czarnik
1

  1. Department of Anesthesiology and Intensive Care, Institute of Medical Sciences, University of Opole, Poland
  2. Institute of Health Sciences, University of Opole, Poland
Anaesthesiol Intensive Ther 2024; 56, 3: 169–176
Online publish date: 2024/08/30
View full text Get citation
 
PlumX metrics:
Introduction:
The superior vena cava collapsibility index (SVC-CI) is a potential marker of fluid responsiveness (FR) in mechanically ventilated patients. Few studies reporting its diagnostic performance are currently available.

Material and methods:
A systematic search, using the PRISMA approach, was performed using the Medline and EMBASE databases. Prospective studies evaluating the SVC-CI as a marker of FR in ventilated adult patients were included. A bivariate random-effect model was utilised to generate the summary receiver operating characteristic (SROC) curve. The area under the ROC curve (AUC), the sensitivity and specificity of the curve operating point were calculated.

Results:
We included eight studies with a total of 857 patients, in whom SVC-CI was evaluated a total of 1083 times prior to the volume expansion trial. In 609 (56.23%) trial cases FR was present. The SROC curve demonstrated that the test’s operating point has a sensitivity and specificity of 80.8% (95% CI: 66.3–90%) and 81.4% (95% CI: 76.4–85.5%), respectively. The model’s AUC was equal to 0.848 (95% CI: 0.824–0.863) with P < 0.001. No significant inter-study heterogeneity was found (I2 = 0%). A subgroup analysis revealed a significantly lower sensitivity of SVC-CI in patients with higher levels of positive end-expiratory pressure (PEEP) (> 5 cm H2O) (χ2 = 7.753, df = 2, P = 0.0207). The study setting and type of intervention for volume expansion did not significantly change the performance of the test.

Conclusions:
SVC-CI is a reliable predictor of FR for mechanically ventilated patients in intensive care units and operating rooms. A PEEP level exceeding 5 cm H2O may impair the sensitivity of the test.

keywords:

fluid therapy, echocardiography, superior vena cava, fluid responsiveness, superior vena cava collapsibility

Quick links
© 2024 Termedia Sp. z o.o.
Developed by Bentus.