Skip Navigation
Skip to contents

ACC : Acute and Critical Care

OPEN ACCESS
SEARCH
Search

Search

Page Path
HOME > Search
2 "Arti Sharma"
Filter
Filter
Article category
Keywords
Publication year
Authors
Original Articles
Cardiology
Diagnostic accuracy of left ventricular outflow tract velocity time integral versus inferior vena cava collapsibility index in predicting post-induction hypotension during general anesthesia: an observational study
Vibhuti Sharma, Arti Sharma, Arvind Sethi, Jyoti Pathania
Acute Crit Care. 2024;39(1):117-126.   Published online February 23, 2024
DOI: https://doi.org/10.4266/acc.2023.00913
  • 1,934 View
  • 140 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Point of care ultrasound (POCUS) is being explored for dynamic measurements like inferior vena cava collapsibility index (IVC-CI) and left ventricular outflow tract velocity time integral (LVOT-VTI) to guide anesthesiologists in predicting fluid responsiveness in the preoperative period and in treating post-induction hypotension (PIH) with varying accuracy. Methods: In this prospective, observational study on included 100 adult patients undergoing elective surgery under general anesthesia, the LVOT-VTI and IVC-CI measurements were performed in the preoperative room 15 minutes prior to surgery, and PIH was measured for 20 minutes in the post-induction period. Results: The incidence of PIH was 24%. The area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the two techniques at 95% confidence interval was 0.613, 30.4%, 93.3%, 58.3%, 81.4%, 73.6% for IVC-CI and 0.853, 83.3%, 80.3%, 57.1%, 93.8%, 77.4% for LVOT-VTI, respectively. In multivariate analysis, the cutoff value for IVC-CI was >51.5 and for LVOT-VTI it was ≤17.45 for predicting PIH with odd ratio [OR] of 8.491 (P=0.025) for IVCCI and OR of 17.427 (P<0.001) for LVOT. LVOT-VTI assessment was possible in all the patients, while 10% of patients were having poor window for IVC measurements. Conclusions: We recommend the use of POCUS using LVOT-VTI or IVC-CI to predict PIH, to decrease the morbidity of patients undergoing surgery. Out of these, we recommend LVOT-VTI measurements as it has showed a better diagnostic accuracy (77.4%) with no failure rate.

Citations

Citations to this article as recorded by  
  • The Use of the Perfusion Index to Predict Post-Induction Hypotension in Patients Undergoing General Anesthesia: A Systematic Review and Meta-Analysis
    Kuo-Chuan Hung, Shu-Wei Liao, Chia-Li Kao, Yen-Ta Huang, Jheng-Yan Wu, Yao-Tsung Lin, Chien-Ming Lin, Chien-Hung Lin, I-Wen Chen
    Diagnostics.2024; 14(16): 1769.     CrossRef
  • Where the Postanesthesia Care Unit and Intensive Care Unit Meet
    Mary Rose Gaylor, David N. Hager, Kathleen Tyson
    Critical Care Clinics.2024; 40(3): 523.     CrossRef
Gastroenterology
The diagnostic accuracy of ultrasonography over manual aspiration for gastric reserve volume estimation in critically ill patients
Rahul Sharma, Ravi Kant Dogra, Jyoti Pathania, Arti Sharma
Acute Crit Care. 2023;38(1):134-141.   Published online February 22, 2023
DOI: https://doi.org/10.4266/acc.2022.00955
  • 2,749 View
  • 145 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
Although gastric reserve volume (GRV) is a surrogate marker of gastrointestinal dysfunction and feeding intolerance, there is ambiguity in its estimation due to problems associated with its measurement. Introduction of point-of-care ultrasound as a tool for anesthetists kindled interest in its use for GRV estimation. Methods: In this prospective observational study, we recruited 57 critically ill patients and analyzed 586 samples of GRV obtained by both ultrasonography (USG) and manual aspiration. Results: The analysis showed that USG-guided GRV was significantly correlated (r=0.788, P<0.001) and in positive agreement with manual aspiration based on Bland-Altman plot, with a mean difference of 8.50±14.84 (95% confidence interval, 7.389–9.798). The upper and lower limits of agreement were 37.7 and –20.5, respectively, within the ±1.96 standard deviation (P<0.001). The respective sensitivity and positive predictive value, specificity and negative predictive value, and area under the curve of USG for feeding intolerance were 66.67%, 98.15%, and 0.82%, with 96.49% diagnostic accuracy. Conclusions: Ultrasonographic estimation of GRV was positively, significantly correlated and in agreement with the manual aspiration method and estimated feeding intolerance earlier. Routine use of gastric USG could avoid clinical situations where feeding status is unclear and there is high risk of aspiration and could become a standard practice of critical care.

Citations

Citations to this article as recorded by  
  • Correlación de volumen residual gástrico medido y ultrasonido gástrico para identificar intolerancia gástrica en pacientes neurocríticos con nutrición enteral en la unidad de cuidados intensivos
    Mauricio Pérez-Macías, Roxana Vázquez-Ramírez, Marcela Pinedo-Lechuga
    Medicina Crítica.2024; 38(2): 102.     CrossRef
  • Is pre-extubation fasting in ICU justified? Insights from a prospective observational study using gastric ultrasound
    Mohd Saif Khan, Barun Ram, Amit Kumar, Kamel Bousselmi, Priyesh Kumar, Dumini Soren, Priyanka Shrivastava, Naveen Kumar
    Trends in Anaesthesia and Critical Care.2024; 58: 101497.     CrossRef
  • Gastrointestinal function in critically ill patients
    Annika Reintam Blaser, Kaspar F. Bachmann, Adam M. Deane
    Current Opinion in Clinical Nutrition & Metabolic Care.2023; 26(5): 463.     CrossRef

ACC : Acute and Critical Care
TOP