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Subject Area

Pathology

Article Type

Original Study

Abstract

Objective The aim was to determine the correlation of the caval index, inferior vena cava (IVC) diameter, and central venous pressure (CVP) in shocked patients in the emergency room. Background Assessment of intravascular volume is important in shocked patients. It can be measured through many techniques, among those include CVP, collapsibility index, and diameter of IVC. Patients and methods This was a prospective and cross-sectional study and included 100 patients treated at the Emergency Department of Menoufia University Hospital. They were selected according to certain inclusion and exclusion criteria with already inserted central venous catheter and were measured for CVP, and concomitantly the IVC diameter was measured with ultrasound using M-mode to measure the expiratory and inspiratory diameter and collapsibility index of the IVC, and then the patients were divided into three groups according to the CVP, with CVP less than 10, CVP 10–15 and CVP more than 15. Results Among the 100 patients enrolled, the median age was 56.01 ± 20.92 years. The correlation of the CVP measurement with the ultrasound IVC caval index was r= −0.911 (P < 0.001), with the expiratory IVC diameter was r = 0.703 (P < 0.001), and with the inspiratory IVC diameter was r = 0.875 (P < 0.001). The sensitivity and specificity of the caval index showed that the cutoff points were 50, 40, and 20 at CVP levels 10, 10–15, and 15 cm H2 O, respectively. Conclusion This study found that in shocked patients there is a good correlation between CVP and collapsibility index, as well as with inspiratory and expiratory diameter of IVC.

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