Zhang Hao, Jiang Jingyuan, Dai Min, Liang Yan, Li Ningxiang, Gao Yongli
Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Institute of Disaster Medicine, Sichuan University, Chengdu, Sichuan, China.
PLoS One. 2025 May 9;20(5):e0310462. doi: 10.1371/journal.pone.0310462. eCollection 2025.
Existing guidelines emphasize the importance of initial fluid resuscitation therapy in sepsis management. However, in previous meta-analyses, there have been inconsistencies in differentiating between spontaneously breathing and mechanically ventilated septic patients.
To consolidate the literature on the predictive accuracy of changes in the inferior vena cava diameter (∆IVC) for fluid responsiveness in septic patients.
The Embase, Web of Science, Cochrane Library, MEDLINE, PubMed, Wanfang, China National Knowledge Infrastructure (CNKI), Chinese Biomedical (CBM) and VIP (Weipu) databases were comprehensively searched. Statistical analyses were performed with Stata 15.0 software and Meta-DiSc 1.4.
Twenty-one research studies were deemed suitable for inclusion. The sensitivity and specificity of ∆ IVC were 0.84 (95% CI 0.76, 0.90) and 0.87 (95% CI 0.80, 0.91), respectively. With respect to the distensibility of the inferior vena cava (dIVC), the sensitivity was 0.79 (95% CI 0.68, 0.86), and the specificity was 0.82 (95% CI 0.73, 0.89). For collapsibility of the inferior vena cava (cIVC), the sensitivity and specificity values were 0.92 (95% CI 0.83, 0.96) and 0.93 (95% CI 0.86, 0.97), respectively.
The results indicated that ∆IVC is as a dependable marker for fluid responsiveness in sepsis patients. dIVC and cIVC also exhibited high levels of accuracy in predicting fluid responsiveness in septic patients.
现有指南强调初始液体复苏治疗在脓毒症管理中的重要性。然而，在以往的荟萃分析中，区分自主呼吸和机械通气的脓毒症患者时存在不一致性。
汇总关于脓毒症患者下腔静脉直径变化（∆IVC）对液体反应性预测准确性的文献。
全面检索了Embase、科学网、考克兰图书馆、MEDLINE、PubMed、万方、中国知网（CNKI）、中国生物医学文献数据库（CBM）和维普数据库。使用Stata 15.0软件和Meta-DiSc 1.4进行统计分析。
21项研究被认为适合纳入。∆IVC的敏感性和特异性分别为0.84（95%可信区间0.76，0.90）和0.87（95%可信区间0.80，0.91）。关于下腔静脉扩张性（dIVC），敏感性为0.79（95%可信区间0.68，0.86），特异性为0.82（95%可信区间0.73，0.89）。对于下腔静脉塌陷性（cIVC），敏感性和特异性值分别为0.92（95%可信区间0.83，0.96）和0.93（95%可信区间0.86，0.97）。
结果表明，∆IVC可作为脓毒症患者液体反应性的可靠标志物。dIVC和cIVC在预测脓毒症患者液体反应性方面也表现出较高的准确性。
