Comparative study between Inferior Vena Cava Collapsibility Index (IVCCI) and Serum Lactate Level as Weaning Predictors of Vasopressors in Septic Shock Patients

Abstract

Abstract Background Sepsis is a complex disorder that develops as a dysregulated host response to an infection, and is associated with acute organ dysfunction and a high risk of mortality. This syndrome needs urgent treatment, and thus awareness of the presenting characteristics is of great importance. The incidence of sepsis is high, and the condition remains one of the leading causes of death globally. Thus, sepsis is an important public health issue with considerable economic consequences. Aim of the Work to elaborate the effectiveness of IVC collapsibility index versus serum lactate level as predictors for weaning from vasopressors in septic shock patients. Patients and Methods Results There were no statistically significant correlations between vasopressor doses, serum lactate or IVCCI at different time- points. To stratify the predictive value of serum lactate and IVCCI in weaning from vasopressors, patients were divided into 2 groups at the end of the 2nd day and at the end of the 3rd day: Weaned group and non- weaned group. Both groups were compared and performance of serum lactate and IVCCI in prediction of weaning from vasopressors at different time- points was assessed using Receiver Operator Characteristics analysis. At different measurements, IVCCI had larger area under curve with better diagnostic performance than serum lactate in prediction weaning from vasopressors. Conclusion serum lactate and inferior vena cava collapsibility index decrease significantly with improvement of sepsis and subsequent reduction of vasopressor doses. Changes in serum lactate and inferior vena cava collapsibility could predict changes in vasopressor doses with better performance for inferior vena cava collapsibility index.