INFERIOR VENA CAVA COLLAPSIBILITY INDEX AS A NON-INVASIVE METHOD OF ASSESSING THE VOLEMIC STATUS OF PATIENTS DURING SPINE INTERVENTIONS

Abstract

Objective. To prove the possibility of using non-invasive diagnostics of the volemic state of postoperative patients using ultrasound assessment of inferior vena cava collapsibility index. Methods. The study included 67 patients who underwent transpedicular fixation of the spine with laminectomy. Volemiс status was determined for all participants in two ways: by catheterization of the central vein and determination of central venous pressure, as well as by ultrasound examination of the inferior vena cava and calculation of inferior vena cava collapsibility index. Results. According to the results of the invasive assessment of central venous pressure, patients were divided into 3 groups: group I (patients in hypovolemic state, n = 31), group II (patients in euvolemic state, n = 25) and group III (patients in hypervolemic state, n = 11 ). The average values of central venous pressure indicators in patients of these groups were statistically significantly different from each other (p < 0.01). The difference between the mean values of the inferior vena cava collapse index in the respective groups was statistically significant (p < 0.01). A reliable inverse correlation of very high strength was found between the indicators of inferior vena cava collapsibility index and central venous pressure (p < 0.05). Conclusions. Determination of the patient's volemic state is an extremely important tool for the correct selection of the fluid volume management. Ultrasound assessment of volemic status has a number of advantages, such as the non-invasiveness of the method, wide availability, low price and speed of execution. According to the results of our study, the possibility of using inferior vena cava collapsibility index to assess the volemic status of patients has been demonstrated.