Inferior vena cava collapsibility index and stroke volume as predictors of blood transfusion in upper gastrointestinal bleeding in the emergency department

• Published in: Journal of gastroenterology and hepatology Vol. 39; no. 6; pp. 1040 - 1047
• Main Authors: Ayar, Mustafa Selçuk, Baydın, Ahmet, Ustaoglu, Müge, Caliskan, Fatih, Erenler, Ali Kemal
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01-06-2024
• Subjects: Bleeding; Blood transfusion; Blood transfusions; Emergency medical care; Glasgow–Blatchford score; Inferior vena cava collapsibility index; Patients; Rockall score; Stroke volume; Upper gastrointestinal bleeding; Inferior vena cava collapsibility index; Rockall score; Upper gastrointestinal bleeding; Glasgow-Blatchford score; Stroke volume
• ISSN: 0815-9319; 1440-1746; 1440-1746
• DOI: 10.1111/jgh.16500

Background and Aim
This study investigates the effectiveness of bedside ultrasonography in predicting blood transfusion requirements in patients with upper gastrointestinal bleeding (UGIB). It focuses on evaluating the inferior vena cava (IVC) diameter, IVC collapsibility index (CI), and stroke volume (SV) as ultrasonographic measures.
Methods
A hundred adult patients enrolled in this prospective clinical study. The patients were divided into two groups (group 1: only saline administered group, group 2: saline and blood administered group). IVC diameter, IVC CI, and SV were measured at the time of admission and after treatment.
Results
At the initial admission, group 1 exhibited an IVC CI of 20.4% and an SV of 65.0 mL, whereas group 2 displayed an IVC CI of 26.6% and an SV of 58.0 mL. Upon analyzing the relationship between the Glasgow–Blatchford score (GBS) and SV, we identified a significant negative correlation (r = −0.7350; P < 0.001). Similarly, a weak negative correlation was observed between the Rockall score (RS) and SV (r = −0.4718; P < 0.001). It is worth noting that patients with UGIB require blood transfusion if their SV falls below 62.5 mL, with an area under the curve (AUC) of 89.1% and a 95% confidence interval (CI) ranging from 82.8% to 95.4%.
Conclusion
IVC CI and SV can be used as parameters to predict the need for blood transfusion in the ED in patients with UGIB.