On the contrary, no difference was detected by comparing IVCCI basal and post-infusion mean values: 28.
Furthermore, a curvilinear relationship was detected between basal IVCCI and eGFR values in the study population.
IVCCI as a tool for monitoring of intravascular volume in CHF patients: pathophysiologic basis and literature data
This has been confirmed by a recent study in which an IVCCI [less than or equal to] 15% was highly sensitive and specific for the diagnosis of acute decompensated heart failure, whereas the absolute diameter of the IVC in itself was non-diagnostic (28).
In our study we decided to categorize IVCCI values by grouping them in three classes: [less than or equal to] 15%, 16- 40% and >40%.
While planning the study, we considered that the three IVCCI ranges of our study may reflect also different levels of renal function, so as to reproduce the differences found by comparing eGFRs associated with different levels of invasively measured PVC in another previous study (16).
In addition, in IVCCI [less than or equal to] 15% (12 patients), eGFR at admission showed a sharp increase when IVCCI increased from 1 to 15%.
Furthermore, furosemide dosages did not significantly differ by comparing patients across the different IVCCI ranges ([less than or equal to] 15, 16-40 and >40%) during the first 2 days after admission, as individual doses within the first 48 hours were exclusively established on the basis of clinical signs and symptoms.
IVCCI during diuretic unloading therapy: a "window" with the potential for exploring the diuretic--related changes in central venous pressure?
In our study, mean eGFR was demonstrated to decrease after unloading diuretic treatment, while IVCCI mean value was found unchanged.
Finally, due to sometimes insufficient documentation, the evaluation of relations between eGFR and IVCCI might have not enough considered preexisting undiagnosed or subclinical nephropathies responsible for chronic renal damage, which in these cases shouldn't be attributed to chronic heart failure per se.
Occurrence of renal impairment was significantly higher in patients with marked IVC respiratory collapsibility (IVCCI >40%) at admission compared to those with basal IVCCI located in the intermediate range (16-40%).