Caudal vena cava measurements could be helpful in predicting the response to fluids in hospitalized cats with hemodynamic alterations.
This study aimed to evaluate using the caudal vena cava collapsibility index (CVCCI) and the inspiratory/minimum and expiratory/maximum diameters of the vena cava to predict fluid responsiveness in hospitalized, critically ill cats with hemodynamic and tissue perfusion abnormalities.
Twenty-four hospitalized cats with spontaneous breathing, compromised hemodynamics, and tissue hypoperfusion were prospectively included. Ultrasonographic examination before and after fluid expansion with 10 ml/kg of lactated Ringer's solution. Fluid responsiveness was evaluated using the velocity-time integral (VTI) of the subaortic blood flow by measuring it before and after a fluid load of 10 ml/kg of lactated Ringer's solution. The CVCCI was calculated using the following formula: (maximum diameter - minimum diameter / maximum diameter) × 100.
Results showed that 10 cats were fluid responders (42 %) and 14 were nonresponders (58 %). The area under the receiver operating characteristic curve (AUROC) with their 95% confidence interval for the predictors and the best cutoff values were as follows: CVCCI, AUROC = 0.83 (0.66-1.00) and cutoff = 31%; inspiratory/minimum diameter, AUROC = 0.86 (0.70-1.00) and cutoff = 0.24 cm; expiratory/maximum diameter, AUROC = 0.88 (0.74-1.00) and cutoff = 0.22 cm. A significant linear correlation was observed between the percentage of increase in VTI after expansion and CVCCI (rs = 0.68, P < 0.001), expiratory/maximum diameter (rs = -0.72, P < 0.001), and inspiratory/minimum diameter (rs = -0.71, P < 0.001). The intraobserver and interobserver variability was low for VTI, and the expiratory/maximum and inspiratory/minimum diameters were high for CVCCI.
In conclusion, caudal vena cava measurements could be helpful in predicting the response to fluids in hospitalized cats with hemodynamic and tissue perfusion alterations. Additional studies are required to draw definitive conclusions about these variables' role in guiding fluid administration in cats.
“Caudal vena cava measurements and fluid responsiveness in hospitalized cats with compromised hemodynamics and tissue hypoperfusion” Pablo A Donati, et al. J Vet Emerg Crit Care (San Antonio). 2023 Jan;33(1):29-37. doi: 10.1111/vec.13272.
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