Validity of Lung Ultrasound Score and Inferior Vena Cava Diameter Compared to Pulse Pressure Variation Predicting Fluid Responsiveness in Mechanically Ventilated Critically Ill Patients: A Comparative Study

The assessment and regulation of intravascular volume provides a significant problem for critically ill cases.

This study aimed to evaluate the efficacy of IVC and lung ultrasonography compared to pulse pressure differences in expecting fluid responsiveness in cases mechanically ventilated with circulatory failure.

The research has been performed on 150 cases in the ICU of Fayoum University Hospitals with permission from the local institutional ethical committee and the local institutional review board (D 310).

A statistically significant variance has been observed among fluid responders and fluid non-responders with p-value < 0.05 regarding delta lung B lines, inferior vena diameter during both inspiration and expiration, inferior vena cava distensibility index, and pulse pressure variation, while there was a statistically insignificant variance regarding lung B lines, heart rate, central venous pressure, urine output, serum lactate, and ICU stay with p-value more than 0.05. Additionally, the area under the Receiver-Operating Characteristic (ROC) curve and the p-values for various hemodynamic and ultrasound variables were investigated. Variables with p-values fewer than 0.05 (statistically significant) have been shown their sensitivities (true positive), specificities (true negative), and best cut-off values.

Pulse pressure variation, lung ultrasound, and inferior vena cava distensibility index have a predictive value for fluid responsiveness with high specificity and sensitivity.

This study is registered on ClinicalTrials.gov (NCT05980494; principal investigator: Mohamed Ahmed Hamed; date of registration: July 31, 2023).