Validity of Shock Index, Modified Shock Index, Central Venous Pressure and Inferior Vena Cava Collapsibility Index in Evaluation of Intravascular Volume among Hypovolemic Egyptians Patients.

Adel Hamed Elbaih; Ahmed Mohamed Housseini

doi:10.5455/ajdi.20180318114502

Abstract
Introduction: assessment of intravascular volume is an important component in care of hypovolemia. Physical examination is inaccurate tools in the assessment of intravascular volume, leading to the need for more objective method and accuracy tool.
Aims: the prediction of Validation of Shock Index, Modified Shock Index, Central Venous Pressure and Inferior Vena Cava collapsibility index in Assessment of Intravascular Volume.
Methods:-This study was conducted as cross-sectional, observational study on 150 Egyptians patients attending to the Emergency Room with hypovolemia state (systolic blood pressure <90 mmHg, heart rate >100 beat /min and capillary refill >2 sec. and clinical signs with symptoms suggestive any types of shocks.) and all patients enter resuscitation room once they arrive to ER. With Applied resuscitations guidelines methods and treat all the life threading conditions if present to all participants.
Results: The studied patients revealed negative correlation between CVP value and (SI and MSI) but positive correlation with IVC-CI value. And the mean CVP was 3.2 ± 2.2 but the mean collapsibility index of IVC was74.9 ± 10.5%. MSI has 100% sensitivity and 98% specificity,CVP has 100% sensitivity and specificity and IVC-CI has 100% sensitivity and specificity in diagnosis of hypovolemia when > 1.3 ,≤ 8 cmH2O and ≥ 50 % respectively.
Conclusion: assessment of intravascular volume is an important diagnostic tools and management of hypovolemic patients with determining collapsibility (greater than 50%) of the inferior vena cava by bedside ultrasonography in conjunction with common clinical markers predictors e.g. Shock Index, Modified Shock Index and Central Venous Pressure.

Key words: caval index, clinical predictors, Hypovolemia