Comparison of Inferior Vena Cava Distensibility Index and Pulse Pressure Variation as Predictors of Fluid Responsiveness in Sepsis Patients at the ICU

Evandrian, Difa Aulia
Soesilowati, Danu
Rakhmajati, Pradana Bayu

Jurnal Anestesiologi Indonesia
Vol 18, No 1 (2026): JAI (Jurnal Anestesiologi Indonesia)

Background: Sepsis is a major global health challenge with an estimated 49 million incident cases and 11 million deaths each year, which requires appropriate fluid management to improve patient prognosis.Objective: This study aims to compare the effectiveness of the inferior vena cava distensibility index (IVC-DI) and pulse pressure variation (PPV) as predictors of fluid responsiveness in sepsis patients in the intensive care unit (ICU).Methods: This study used an experimental design with a sample of 36 sepsis patients selected through consecutive sampling. Fluid administration of 500 ml RL was carried out for 15 minutes, followed by measurement of IVC-DI and PPV, and evaluation of an increase in stroke volume (SV) > 15% as an indicator of fluid responsiveness.Results: The study showed that PPV had a sensitivity of 93% and specificity of 90%, with a positive predictive value of 87.5% and a negative predictive value (NPV) of 95%. The overall accuracy of PPV was 91.6%. PPV showed a very strong correlation with SV increase > 15% (r = 0.832, p < 0.001). On the other hand, IVC-DI had a sensitivity of 80% and specificity of 71%, with a positive predictive value of 66% and a NPV of 83%. The overall accuracy of the IVC-DI was 75%. The IVC-DI showed moderate correlation with SV increase > 15% (r = 0.507, p = 0.002). Inter-observer agreement in IVC-DI measurements also showed excellent results with a Kappa value of 1.00, indicating perfect agreement. From the results of this study, PPV proved to be more accurate in predicting fluid responsiveness compared to IVC-DI in sepsis patients in the ICU. These two methods, although equally useful, showed different levels of effectiveness in this clinical context.Conclusion: PPV showed better performance than IVC-DI in predicting fluid responsiveness in mechanically ventilated sepsis patients in the ICU. PPV demonstrated higher accuracy, sensitivity, specificity, and a stronger correlation with SV improvement, indicating that PPV may serve as a more reliable predictor in this clinical setting.