Accuracy of inferior vena cava parameters measured by ultrasound in predicting post-induction hypotension in patients undergoing general anesthesia: a meta-analysis
10.3760/cma.j.cn131073.20240520.01109
- VernacularTitle:超声测量下腔静脉参数预测全麻诱导后低血压的准确性：meta分析
- Author:
Xiaoying WANG
1
;
Qun ZHOU
;
Ju GAO
;
Tianfeng HUANG
;
Zhongnan XU
Author Information
1. 江苏省苏北人民医院麻醉科，扬州 225000
- Keywords:
Vena cava, inferior;
Ultrasonography;
Hypotension;
Meta-analysis;
Anesthesia induction
- From:
Chinese Journal of Anesthesiology
2024;44(11):1323-1332
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the accuracy of inferior vena cava (IVC) parameters measured by ultrasound in predicting post-induction hypotension(PIH) in patients undergoing general anesthesia using a meta-analysis.Methods:Databases such as China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database, PubMed, Cochrane Library and Embase were searched for diagnostic clinical trials that involved IVC parameters such as IVC collapsibility index (IVCCI), maximum and minimum IVC diameters (dIVCmax, dIVCmin) measured by ultrasound that predicted PIH from inception to May 2022. Primary outcomes were sensitivity, specificity, and the area under the receiver operating characteristic curve of each parameter. The meta regression analysis and subgroup analysis were used to explore the sources of heterogeneity.Results:Nineteen articles were ultimately included ( n=1 750). The sensitivity and specificity of IVCCI in predicting PIH were 0.73 and 0.82 respectively, and the area under the summary receiver operating characteristic curve(AUSROC) was 0.85, and the prediction threshold of IVCCI was (42.5±6.8)%. The sensitivity and specificity of dIVCmax in predicting PIH were 0.46 and 0.74 respectively, and the AUSROC was 0.64. The sensitivity and specificity of dIVCmin in predicting PIH were 0.69 and 0.66 respectively, and the AUSROC was 0.72. In subgroup analysis, the AUSROC of IVCCI in predicting PIH in etomidate subgroup and non-immediate measurement before induction subgroup was 0.92 and 0.71 respectively. The AUSROC of IVCCI was all between 0.8 and 0.9 in propofol group, fentanyl group, sufentanil group, ARB/ACEI group, unlimited surgical types group, and combined with vascular diseases group and other subgroups. Conclusions:IVCCI measured by ultrasound can moderately predict PIH, and dIVCmax and dIVCmin have low accuracy in predicting PIH. Immediate measurement before induction and use of etomidate can improve the predictive accuracy of IVCCI. The predictive accuracy of IVCCI is not affected by the type of opioid drugs, type of surgery, use of ARB/ACEI antihypertensive drugs or vascular diseases.
