Correlation of Ultrasonographic Measurement of Inferior Vena Cava Collapsibility Index with Central Venous Pressure in Diagnosis and Management of Neonatal Shock

Abstract

Background: Neonatal intensive care unit (NICU)Conventionally, Central Venous Pressure (CVP) monitoring has beenused by intensivists to measure intravascular volume. However, it is an invasive procedure resulting in many complications. Non-invasive ultrasonographic measurement of inferior vena cava collapsibility index (IVC-CI) is a promising alternative. Therefore, this study wasconducted to evaluate the correlation of central venous pressure with IVC-CIand establish the cut off valuesfor IVC-CI to diagnose and manage neonatal shock.Methods: The current research was a prospective longitudinal study.All sick neonates requiring intensive hemodynamic monitoring were enrolled in the study and umbilical vein catheterization was performedto measure CVP. IVC diameters and IVC-CI were measured using ultrasound. Based on CVP, the patients were classified into three categories: hypovolemic (CVP8 cmH2O) and managed with intravenous fluid boluses and/or inotropes, accordingly. CVP and IVC-CI were again recorded after the intervention and compared with the previous values.Results: A total of 76(62.3%) males and 46 (37.7%) females were included in the study with a mean age of 27.16±17.5 years. There was a strong negative correlation,which was statistically significant, between CVP and IVC-CI (r= -0.913, n=122, P8 cmH2O with 91.1% sensitivity, 83.2% speci icity, 71.8% positive predictive value and 50.6% negative predictive value.Conclusion: The obtained results revealed an inverse correlation between CVP and IVC-CI, and it was concluded that IVC-CI can provide a useful guide in the diagnosis and management of shock in sick newborns.

Keywords

• central venous pressure(cvp)
• management
• neonates
• shock
• ultrasound