EGDT Modifications Using IVC Diameter And IVC Collapsibility Index To Provide Intravascular Adequacy For Sepsis Management In Remote Areas

Early goal directed therapy (EGDT) protocols can still be considered to provide clear guidelines for bedside clinicians to treat sepsis. The use of EGDT protocols requires central venous catheter (CVC) installation to calculate the central venous pressure (CVP). In the field, especially in remote areas, the installation of a CVC often cannot be done due to unavailability of tools or other reasons. Wiryana et al. found that there was a strong negative correlation between CVP and collapsibility index of the inferior vena cava (IVC) and that the IVC collapsibility index (IVC-CI) could replace CVP. 1 Therefore, IVC-CI could be used to replace the role of CVP on modified EGDT protocols. The IVC diameter and IVC-CI was measured on 5 patients after initial fluid therapy. There was an expiratory IVC diameter and a IVC-CI belonging to the CVP group of 11-15 cm H 2 O according to Katja, et al.