The Role of Inferior Vena Cava Diameter Variation ratio Measured by Ultrasonography versus Central Venous Pressure in Assessment Of Volume Responsiveness of Shocked Hepatic Patients

Abstract

Liver cirrhosis is a major cause of morbidity and mortality in chronic liver disease patients which is multifactorial in nature, leading to several complications including ascites, variceal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis and hepatorenal syndrome. Also, cirrhotic patients have circulatory changes with high cardiac output and low systemic vascular resistance, rendering them more susceptible to develop circulatory dysfunction and shock due to its complications with end result of multiple organ failure. Circulatory failure in complicated cirrhotic patients is either distributive as in spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome (HRS), or hypovolemic as in variceal bleeding characterized by a greater decrease in arterial pressure associated with signs of impaired tissue perfusion, requiring prompt volume resuscitation to avoid lethal complications of irreversible shock stage