Evidence map›Paper›PMID 37755657›Full record

Trial reportCJEM2023

SHoC-IVC: Does assessment of the inferior vena cava by point-of-care ultrasound independently predict fluid status in spontaneously breathing patients with undifferentiated hypotension?

Robert Dunfield, Peter Ross, Daniel Dutton, Kavish Chandra, David Lewis, Frank Scheuermeyer, Jacqueline Fraser, Patrick Boreskie, Chau Pham, Sultan Ali and 5 more

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in CJEM, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 6 institutions in 2 countries.

Robert DunfieldDepartment of Emergency Medicine, Dalhousie Medicine New Brunswick, Horizon Health Network, Saint John, NB, Canada.
Peter RossDepartment of Emergency Medicine, Dalhousie Medicine New Brunswick, Horizon Health Network, Saint John, NB, Canada.
Daniel DuttonDepartment of Emergency Medicine, Dalhousie Medicine New Brunswick, Horizon Health Network, Saint John, NB, Canada.
Kavish ChandraDepartment of Emergency Medicine, Dalhousie Medicine New Brunswick, Horizon Health Network, Saint John, NB, Canada.
David LewisDepartment of Emergency Medicine, Dalhousie Medicine New Brunswick, Horizon Health Network, Saint John, NB, Canada.
Frank ScheuermeyerDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Jacqueline FraserDepartment of Emergency Medicine, Horizon Health Network, Saint John, NB, Canada.
Patrick BoreskieDepartment of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada.
Chau PhamDepartment of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada.
Sultan AliDepartment of Emergency Medicine, Dalhousie Medicine New Brunswick, Horizon Health Network, Saint John, NB, Canada.
Hein LamprechtDivision of Emergency Medicine, University of Stellenbosch, Cape Town, South Africa.
Melanie StanderDivision of Emergency Medicine, University of Stellenbosch, Cape Town, South Africa.
Cameron KeyesSt. Francis Xavier University, Antigonish, NS, Canada.
Ryan HenneberryDepartment of Emergency Medicine, Dalhousie University, Halifax, NS, Canada.
Paul AtkinsonDepartment of Emergency Medicine, Dalhousie Medicine New Brunswick, Horizon Health Network, Saint John, NB, Canada. Paul.Atkinson@Dal.ca.ORCID 0000-0001-9900-4594
Horizon Health Network · CAStellenbosch University · ZAUniversity of Manitoba · CADalhousie University · CASt. Francis Xavier University · CAUniversity of British Columbia · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurately determining the fluid status of a patient during resuscitation in the emergency department (ED) helps guide appropriate fluid administration in the setting of undifferentiated hypotension. Our goal was to determine the diagnostic utility of point-of-care ultrasound (PoCUS) for inferior vena cava (IVC) size and collapsibility in predicting a volume overload fluid status in spontaneously breathing hypotensive ED patients.

methodsThis was a post hoc secondary analysis of the SHOC-ED data, a prospective randomized controlled trial investigating PoCUS in patients with undifferentiated hypotension. We prospectively collected data on IVC size and collapsibility for 138 patients in the PoCUS group using a standard data collection form, and independently assigned a fluid status (volume overloaded, normal, volume deplete) from a composite clinical chart review blinded to PoCUS findings. The primary outcome was the diagnostic performance of IVC characteristics on PoCUS in the detection of a volume overloaded fluid status.

resultsOne hundred twenty-nine patients had completed determinant IVC assessment by PoCUS, with one hundred twenty-five receiving successful final fluid status determination, of which one hundred and seven were classified as volume deplete, thirteen normal, and seven volume overloaded. A receiver operating characteristic (ROC) curve was plotted using several IVC size and collapsibility categories. The best overall performance utilized the combined parameters of a dilated IVC (> 2.5 cm) with minimal collapsibility (less than 50%) which had a sensitivity of 85.7% and specificity of 86.4% with an area under the curve (AOC) of 0.92 for predicting an volume overloaded fluid status.

conclusionIVC PoCUS is feasible in spontaneously breathing hypotensive adult ED patients, and demonstrates potential value as a predictor of a volume overloaded fluid status in patients with undifferentiated hypotension. IVC size may be the preferred measure.

Indexed as

Heart FailureHypotensionAdultHumansPoint-of-Care SystemsProspective StudiesUltrasonographyVena Cava, InferiorEmergency departmentFluid statusHypotensionInferior vena cavaPoint-of-care ultrasound

Identifiers

PMID37755657
OpenAlexW4387077665

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.