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Republication: Correlations between venous collapsibility and common hemodynamic and ventilatory parameters: A multivariable assessment

Introduction: Although the venous collapsibility index (VCI) and central venous pressure (CVP) have been shown to correlate reasonably well, little has been reported on the relationships between VCI and other commonly used hemodynamic variables (i.e., HR, blood pressure). This is a retrospective, post hoc analysis of data from a recently completed 3-year prospective study of VCI in critically ill and injured patients. Materials and Methods: A total of 267 previously recorded data pairs in a group of 82 adults (≥18 to <90 years) patients were included in this analysis. Subsequent correlations were performed between VCI and the following clinical parameters: (a) Heart rate (HR), (b) systolic blood pressure (SBP), (c) diastolic blood pressure (DBP), (d) mean arterial pressure (MAP), (e) pulse pressure, (f) abdominal perfusion pressure (APP or MAP-CVP), (g) positive end-expiratory pressure (PEEP), head-of-bed elevation, and (h) HR-blood pressure index (i.e., HR minus MAP). In addition, correlations between inferior vena cava (IVC) maximum diameter (cm) and demographic variables (age, gender) were performed. Results: Male patients had significantly greater maximum IVC diameters (2.12 ± 0.89 cm) than female patients (1.81 ± 0.61 cm,P< 0.01). We also observed a statistically significant increase in maximum IVC diameter with increasing age, where patients ages 18–44 had mean maximum IVC diameters of 1.81 ± 0.67 and patients ages 45–90 had mean maximum IVC diameters of 2.04 ± 0.78 (P < 0.05). Statistically significant correlations were found between VCI and DBP (R = 0.217,P< 0.03), PEEP (−0.25,P< 0.01), APP (R = 0.23,P< 0.01), and CVP (R = −0.395,P< 0.01). In addition, in patients who were noted to have clinically and/or hemodynamically “discrepant” VCI and CVP measurements, a high VCI (>50%) more accurately correlated to expected SBP and DBP behavior. Conclusions: These preliminary results suggest that DBP may correlate with volume status-based VCI behavior than either SBP or MAP and that VCI may be more accurate in patients experiencing intravascular volume depletion. While these findings are not entirely surprising, further studies are warranted to improve our understanding of the clinical implications and relevance of these findings. The following core competencies are addressed in this article: Medical knowledge, Patient care. Republished with permission from: Patil P, Kelly N, Papadimos TJ, Bahner DP, Stawicki SP. Correlations between venous collapsibility and common hemodynamic and ventilatory parameters: A multi-variable assessment. OPUS 12 Scientist 2014;8(1):1-5.