Inferior vena cava peak velocity versus collapsibility index to predict volume status in patients with gastrointestinal bleeding: A pilot study
- 1Department of Emergency Medicine, Erzurum City Hospital, Erzurum, Türkiye
- 2Department of Emergency Medicine, Aydin Adnan Menderes University Faculty of Medicine, Aydin, Türkiye
- 3Department of Emergency Medicine, Bilecik Training and Research Hospital, Bilecik, Türkiye
Abstract
OBJECTIVES:: Patients presenting to the emergency department (ED) with hemorrhagic shock secondary to acute gastrointestinal (GI) bleeding represent a substantial proportion of the critically ill population. Accurate evaluation of intravascular volume status in these patients is crucial for guiding fluid resuscitation. However, the limitations of invasive methods and inferior vena cava (IVC) diameter/collapsibility measurements in assessing intravascular volume have been widely discussed in the literature. Despite their validation, noninvasive hemodynamic monitoring techniques remain underutilized in the ED. Therefore, the present study aimed to investigate the predictive value of IVC blood flow velocity measured by Doppler ultrasonography in intravascular volume assessment and to compare it with the IVC collapsibility index. Electrical velocity measurement was used as a surrogate marker of volume deficit.
METHODS:: Eighteen patients presenting with a preliminary diagnosis of acute GI bleeding were included in the study. The study population consisted solely of patients with suspected hypovolemia; therefore, no normovolemic control group was included in the study. Demographic, vital, and laboratory data were recorded, along with IVC diameter, collapsibility, IVC peak velocity measured by continuous-wave Doppler, and noninvasive hemodynamic monitoring parameters at admission, at the 30th and 60th min, and immediately after completion of fluid replacement. All data were subjected to statistical analysis.
RESULTS:: A significant correlation was observed between initial IVC peak velocity and stroke volume variation at admission (P = 0.009). The measurement demonstrated a specificity of 100% and a sensitivity of 84%, although the confidence interval was wide due to the small number of patients without volume deficit. No statistically significant differences were detected at the other time points. This can be explained by the ongoing bleeding and the lack of a valid gold standard.
CONCLUSION:: Measurement of IVC peak velocity was found to be a significant predictor of hypovolemia, although it showed limited utility for volume monitoring. Furthermore, it demonstrated superior performance compared to IVC diameter and collapsibility measurements. However, the study does not evaluate its ability to distinguish hypovolemia from true normovolemia.
Related
- Tranexamic acid use and progression to clinically important bleeding in critically ill patients with non-clinically important non-variceal upper gastrointestinal bleeding: a retrospective cohort study
- Validation and Performance of Five Upper Gastrointestinal Bleeding Prognostication Scores in a Single-Centre United Kingdom Cohort of over 1000 Patients
- Prognostic value of scoring systems in geriatric patients receiving warfarin presenting with upper gastrointestinal bleeding
- CO038 | PROGNOSTIC PERFORMANCE OF BLEEDING SEVERITY CLASSIFICATIONS IN HOSPITALIZED PATIENTS WITH GASTROINTESTINAL BLEEDING ON DIRECT ORAL ANTICOAGULANTS
- Outcome-Specific Performance of HALP, AIMS65, Glasgow–Blatchford, and Rockall Scores in Emergency Department Patients with Acute Upper Gastrointestinal Bleeding: A Retrospective Cohort Study
BibTeX
@article{buyuktas2026inferior,
title = {{Inferior vena cava peak velocity versus collapsibility index to predict volume status in patients with gastrointestinal bleeding: A pilot study}},
author = {Onur Cem Büyüktaş and Yunus Emre Özlüer and Ahmet Melih Savaş and Ertuğ Dinçer},
journal = {Turkish Journal of Emergency Medicine},
year = {2026},
month = oct,
doi = {10.4103/tjem.tjem_353_25},
url = {https://doi.org/10.4103/tjem.tjem_353_25},
note = {CC BY-NC-SA 4.0},
}
RIS
TY - JOUR
TI - Inferior vena cava peak velocity versus collapsibility index to predict volume status in patients with gastrointestinal bleeding: A pilot study
AU - Onur Cem Büyüktaş
AU - Yunus Emre Özlüer
AU - Ahmet Melih Savaş
AU - Ertuğ Dinçer
PY - 2026
DA - 2026/10/10
JO - Turkish Journal of Emergency Medicine
DO - 10.4103/tjem.tjem_353_25
UR - https://doi.org/10.4103/tjem.tjem_353_25
AB - OBJECTIVES:: Patients presenting to the emergency department (ED) with hemorrhagic shock secondary to acute gastrointestinal (GI) bleeding represent a substantial proportion of the critically ill population. Accurate evaluation of intravascular volume status in these patients is crucial for guiding fluid resuscitation. However, the limitations of invasive methods and inferior vena cava (IVC) diameter/collapsibility measurements in assessing intravascular volume have been widely discussed in the literature. Despite their validation, noninvasive hemodynamic monitoring techniques remain underutilized in the ED. Therefore, the present study aimed to investigate the predictive value of IVC blood flow velocity measured by Doppler ultrasonography in intravascular volume assessment and to compare it with the IVC collapsibility index. Electrical velocity measurement was used as a surrogate marker of volume deficit. METHODS:: Eighteen patients presenting with a preliminary diagnosis of acute GI bleeding were included in the study. The study population consisted solely of patients with suspected hypovolemia; therefore, no normovolemic control group was included in the study. Demographic, vital, and laboratory data were recorded, along with IVC diameter, collapsibility, IVC peak velocity measured by continuous-wave Doppler, and noninvasive hemodynamic monitoring parameters at admission, at the 30th and 60th min, and immediately after completion of fluid replacement. All data were subjected to statistical analysis. RESULTS:: A significant correlation was observed between initial IVC peak velocity and stroke volume variation at admission (P = 0.009). The measurement demonstrated a specificity of 100% and a sensitivity of 84%, although the confidence interval was wide due to the small number of patients without volume deficit. No statistically significant differences were detected at the other time points. This can be explained by the ongoing bleeding and the lack of a valid gold standard. CONCLUSION:: Measurement of IVC peak velocity was found to be a significant predictor of hypovolemia, although it showed limited utility for volume monitoring. Furthermore, it demonstrated superior performance compared to IVC diameter and collapsibility measurements. However, the study does not evaluate its ability to distinguish hypovolemia from true normovolemia.
SN - 2452-2473
ER -