# Predictive accuracy of changes in the inferior vena cava diameter for predicting fluid responsiveness in patients with sepsis: A systematic review and meta-analysis

## TL;DR

This study reviews and analyzes the accuracy of changes in the inferior vena cava diameter for predicting fluid responsiveness in sepsis patients.

## Contribution

The study consolidates evidence on ∆IVC, dIVC, and cIVC for fluid responsiveness in septic patients through a systematic review and meta-analysis.

## Key findings

- ∆IVC showed high sensitivity and specificity for predicting fluid responsiveness in sepsis patients.
- dIVC and cIVC also demonstrated strong predictive accuracy for fluid responsiveness.
- The study clarifies the effectiveness of IVC measurements in both spontaneously breathing and ventilated septic patients.

## Abstract

Existing guidelines emphasize the importance of initial fluid resuscitation therapy in sepsis management. However, in previous meta-analyses, there have been inconsistencies in differentiating between spontaneously breathing and mechanically ventilated septic patients.

To consolidate the literature on the predictive accuracy of changes in the inferior vena cava diameter (∆IVC) for fluid responsiveness in septic patients.

The Embase, Web of Science, Cochrane Library, MEDLINE, PubMed, Wanfang, China National Knowledge Infrastructure (CNKI), Chinese Biomedical (CBM) and VIP (Weipu) databases were comprehensively searched. Statistical analyses were performed with Stata 15.0 software and Meta-DiSc 1.4.

Twenty-one research studies were deemed suitable for inclusion. The sensitivity and specificity of ∆ IVC were 0.84 (95% CI 0.76, 0.90) and 0.87 (95% CI 0.80, 0.91), respectively. With respect to the distensibility of the inferior vena cava (dIVC), the sensitivity was 0.79 (95% CI 0.68, 0.86), and the specificity was 0.82 (95% CI 0.73, 0.89). For collapsibility of the inferior vena cava (cIVC), the sensitivity and specificity values were 0.92 (95% CI 0.83, 0.96) and 0.93 (95% CI 0.86, 0.97), respectively.

The results indicated that ∆IVC is as a dependable marker for fluid responsiveness in sepsis patients. dIVC and cIVC also exhibited high levels of accuracy in predicting fluid responsiveness in septic patients.