Predicting and measuring fluid responsiveness by hemodynamic indices versus transthoracic echocardiography in patients with clinical shock

Document Type : Original Article

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Department of Anesthesiology Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Egypt.

10.21608/egja.2025.381932.1064

Abstract

Background: In recent decades, dynamic measures have emerged as a more effective method for predicting fluid responsiveness in patients with clinical shock. Among various dynamic parameters, we chose transthoracic echocardiographic-based measurements of variations in aortic blood flow and the inferior vena cava diameter.
Aim: This study aimed to assess the accuracy of transthoracic echo-measured variation in aortic blood flow and the inferior vena cava diameter upon limited bolus crystalloid infusion in predicting fluid responsiveness in patients with clinical shock.
Patients and Methods: This study included 51 patients diagnosed with acute circulatory failure secondary to clinical shock who were admitted to the intensive care unit. All patients underwent the standard transthoracic echocardiographic assessment of the aortic blood flow (using left ventricular outflow tract velocity time integral as a surrogate) and changes in inferior vena cava diameter during the respiratory cycle. These evaluations were conducted at the time of shock diagnosis and repeated after infusion of a 300-mL crystalloid fluid bolus (over 15 min).
Results: A notable distinction was observed between the respondents and non-respondents in terms of aortic flow variation after 15 min.
Conclusion: Transthoracic echocardiography can be used as an accurate method for predicting fluid responsiveness in patients with shock after a fluid challenge.

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