The role of right ventricular volumes and inferior vena cava diameters in the evaluation of volume status before colonoscopy

Abstract

Background/aim: Ultrasonographic measurements of inferior vena cava (IVC) diameters and right ventricle (RV) volumes areimportant tools for the evaluation of intravascular volume. The current study investigates the association of IVC diameters and RVvolumes before colonoscopy in prediction of postanesthesia hypotension.Materials and methods: Seventy patients scheduled for colonoscopy were included in the study. Preoperatively, expirium (dIVC max)and inspirium (dIVC min) IVC diameters were measured using M-mode ultrasonography and the collapsibility index (IVC-CI) wascalculated. Ventricular volumes and areas were also measured using transthoracic echocardiography. Postanesthesia hypotension wasdefined as mean arterial blood pressure of 30% in the mean arterial pressure after sedation.Results: Minimum and maximum IVC diameters were significantly lower (P = 0.005 and P < 0.001, respectively) and IVC-CI wassignificantly higher (P < 0.001) in patients who developed hypotension. Similarly, right ventricular end-diastolic area (RV-EDA), rightventricular end-systolic area (RV-ESA), right ventricular end-diastolic volume (RV-EDV), right ventricular end-systolic volume (RVESV), and left ventricular end-systolic volume (LV-ESV) values were significantly lower in patients with hypotension (P < 0.05). Logisticregression analysis showed that dIVC min and RV-ESA were independent predictors of hypotension.Conclusion: IVC diameters and RV-ESA, RV-EDA, RV-ESV, and RV-EDV are good indicators of preoperative volume status and can beused to predict the patients at risk of developing hypotension.