Prospective observational study to compare subclavian vein collapsibility index with inferior vena cava collapsibility index in predicting hypotension after induction of general anaesthesia.
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Date
2024-09
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Dr. M. V. Ghorpade
Abstract
Background: Intraoperative hypotension leads to many postoperative complications which can be avoidable. In contrast with inferior vena cava, subclavian vein collapsibility index is found to be a better predictor of intravascular volume status. Aim and Objectives: To compare subclavian vein/infraclavicular axillary vein collapsibility index with inferior vena cava collapsibility index (during spontaneous breathing or deep inspiration) in predicting hypotension after induction of general anesthesia. Material and Methods: In this study, 70 ASA I and II healthy individuals were enrolled. Using ultrasonography, diameters of subclavian vein and inferior venacava during one respiratory cycle were recorded and their collapsibility indices were calculated. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Mean Arterial Pressure (MAP) were noted at every 2 minutes interval after induction of general anesthesia. Intraoperative blood pressure measurements were correlated with the collapsibility indices of great veins to predict intraoperative hypotension. Results: MAP at 2, 4, 6 and 8 minutes showed insignificant correlation with the inferior vena cava collapsibility index on spontaneous breathing with values of 'p' being 0.63, 0.98, 0.93 and 0.65, respectively. MAP at 2, 4, 6 and 8 minutes showed insignificant correlation with the inferior vena cava collapsibility index on deep inspiration with values of 'p' being 0.78, 0.20, 0.17 and 0.20, respectively. MAP at 2, 4, 6 and 8 minutes showed very significant correlation with the subclavian vein's collapsibility index on spontaneous breathing with values of 'p' being 0.48, 0.20, 0.17 and 0.20, respectively. MAP at 2, 4, 6 and 8 minutes showed very significant correlation with the subclavian vein's collapsibility index on deep inspiration with values of 'p' being 0.0010, 0.0020, 0.0007 and 0.0012, respectively. Conclusion: Subclavian vein collapsibility index on spontaneous breathing and deep inspiration had highly substantial association with the MAP, as compared to inferior vena cava collapsibility indices.
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Keywords
Intraoperative Hypotension, Subclavian Vein Collapsibility Index, Inferior Venacava Collapsibility Index, Spontaneous Breathing, Deep Breathing
Citation
Patil MC, Kola HP, Kalal RH. . Prospective observational study to compare subclavian vein collapsibility index with inferior vena cava collapsibility index in predicting hypotension after induction of general anaesthesia.. Journal of Krishna Institute of Medical Sciences University. 2024 Sep; 13(3): 80-89