Evaluation of Caval Index to Estimate Low CVP in Comparison with Invasive Method in Patients Admitted In ICU of Bahonar Hospital

Abstract

Introduction: Measurement of central venous pressure can be regarded as a beneficial guide in order to assess a patient's hemodynamic status, specifically in patient with sever sepsis and septic shock, for whom a central venous pressure of less than 8mmhg is considered as an indicator for aggressive intravenous fluid replacement. Therefore, this study aimed to investigate the ultrasonographic examination of the inferior vena cava as well caval index in order to estimate low CVP. Methods: This prospective study was performed on 70 patients admitted in ICU of Shahid Bahonar hospital of Kerman who were all reported to utilize central venous catheter. IVC diameter was measured via applying bedside ultrasonography, first at end of inhalation and, second at the end of exhalation. Caval index, indicating the relative decrease in IVC diameter from inhalation to exhalation, was measured via utilizing CVP monitoring. Results: The study results indicated a positive correlation between inspiratory and expiratory IVC diameter and CVP measurement. The sensitivity of caval index of greater that 50% to predict a low CVP (8mmhg) was reported 94% and it demonstrated the specificity of 97%, as well. Conclusion: As CVP monitoring is an invasive process, in emergency, ultrasonography can be utilized as an accurate tool to determine low CVP as well as the need for aggressive fluid replacement.

Keywords

• Caval Index; CVP
• Inferior Vena Cava