title: Distensibility index of the inferior vena cava in experimental acute respiratory distress syndrome.
abstract: We determined the accuracy of distensibility index of inferior vena cava (dIVC) for evaluation of fluid responsiveness in rats with acute respiratory distress syndrome (ARDS) and validated this index for use in rat models. In protocol 1, E. coli lipopolysaccharide was administered in Wistar rats (n=7). After 24h, animals were mechanically ventilated, and stroke volume (SV) and dIVC quantified after blood drainage and subsequent volume expansion (albumin 20%). A receiver operating characteristic (ROC) curve was plotted to determine the optimal dIVC cutoff. In protocol 2, rats (n=10) were divided into fluid-responders (SV increase >5%) and nonresponders (SV increase <5%). The dIVC cutoff obtained from protocol 1 was 25%. Fluid responders had a 2.5 relative risk of low dIVC (<25%). The sensitivity, specificity, positive predictive, and negative predictive values for dIVC were 74%, 62%, 59%, and 76%, respectively. In conclusion, a dIVC threshold <25% was associated with positive response after volume expansion and could be used to titrate fluids in endotoxin-induced ARDS.
authors.affiliation: Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Mendes
authors.affiliation: Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Brazil.
authors.forename: M V
authors.initials: MV
authors.lastname: Oliveira
authors.affiliation: Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Brazil.
authors.forename: G A
authors.initials: GA
authors.lastname: Padilha
authors.affiliation: Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Brazil.
authors.forename: R S
authors.initials: RS
authors.lastname: Santos
authors.affiliation: Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Brazil; Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Brazil.
authors.forename: N N
authors.initials: NN
authors.lastname: Rocha
authors.affiliation: Institute of Public Health Studies, Federal University of Rio de Janeiro, Brazil.
authors.forename: R R
authors.initials: RR
authors.lastname: Luiz
authors.affiliation: Department of Anesthesiology and Intensive Care Therapy, Pulmonary Engineering Group, University Hospital Dresden, Technische Universität Dresden, Dresden, Germany.
authors.forename: M G
authors.initials: MG
authors.lastname: Abreu
authors.affiliation: Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, IRCCS AOU San Martino - IST, Genoa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Pelosi
authors.affiliation: Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Brazil.
authors.forename: P R M
authors.initials: PRM
authors.lastname: Rocco
authors.affiliation: Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Brazil. Electronic address: pedrolemesilva@gmail.com.
authors.forename: P L
authors.initials: PL
authors.lastname: Silva
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D004195:Disease Models, Animal; D008070:Lipopolysaccharides / Q000633:toxicity; D012372:ROC Curve; D051381:Rats; D017208:Rats, Wistar; D012128:Respiratory Distress Syndrome / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000503:physiopathology*
chemical_list: D008070:Lipopolysaccharides
keywords: Acute respiratory distress syndrome; Albumin; Distensibility index of the inferior vena cava; Fluids; Ultrasonography