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Critical Care

, 19:P187 | Cite as

Assessing fluid status with the vascular pedicle width: relationship to IVC diameter, IVC variability and lung comets

  • N Salahuddin
  • I Hussain
  • Q Shaikh
  • M Joseph
  • H Alsaidi
  • K Maghrabi
Open Access
Poster presentation
  • 222 Downloads

Keywords

Chest Radiograph Fluid Balance Classification Rate Correct Classification Multivariate Linear Regression 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

This study attempts to determine a vascular pedicle width (VPW) cutoff value that identifies a fluid replete state defined as an IVC diameter ≥2 cm and ≤15% respiratory variation.

Methods

In a cross-sectional design, consecutive, critically ill patients underwent simultaneous chest radiographs and ultrasounds. The Research Ethics Committee approved the study.

Results

Eighty-four data points on 43 patients were collected. VPW correlated with IVC diameter (r = 0.64, P ≤0.001) and IVC variation (r = -0.55, P ≤0.001). No correlation was observed between VPW and number of lung comets (r = 0.12, P = 0.26) or positive fluid balance (r = 0.3, P = 0.058). On multivariate linear regression, standardized coefficients demonstrated that a 1 mm increase in IVC diameter corresponded to a 0.28 mm (Beta) increase in VPW. ROC curve analysis yielded an AUC of 0.843 (95% CI = 0.75 to 0.93), P ≤0.001 and provided the best accuracy with a cutoff VPW value of 64 mm (sensitivity 81%, specificity 78%, PPV = 88.5%, NPV = 66%, correct classification rate = 79.6%). See Figure 1.
Figure 1

ROC curve for VPW discriminating fluid repletion by IVC ultrasound.

Conclusion

A VPW value of 64 mm accurately identifies a fluid replete state. Increased extravascular lung water, however, was not relatable to the VPW measurements. The VPW can be confidently used to discriminate fluid repletion from fluid responsiveness.

Copyright information

© Salahuddin et al.; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of 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. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • N Salahuddin
    • 1
  • I Hussain
    • 1
  • Q Shaikh
    • 1
  • M Joseph
    • 1
  • H Alsaidi
    • 1
  • K Maghrabi
    • 1
  1. 1.King Faisal Specialist Hospital & Research CentreRiyadhSaudi Arabia

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