Hemodynamics, fluids & transfusion
Assessing venous congestion in critical illness: advantages of the inferior vena cava shape change index over diameter
Authors' conclusion
The SCI of IVC demonstrates superior diagnostic performance compared with IVC diameter for the identification of venous congestion in critically ill patients, particularly at earlier or less advanced stages.
Study context
- Population
- Critically ill adults undergoing bedside ultrasonography; venous congestion graded by hepatic, portal and renal venous Doppler (Grade 0–3)
- Participants
- 84 adults · 116 venous Doppler examinations
- Comparison
- Shape Change Index (SCI) of inferior vena cava (IVC) vs IVC diameter for detecting venous congestion
- Outcome
- Diagnostic performance (ROC analysis) for detecting venous congestion
Methodological detailsprospective
- Prospective
Performance
As reported in the abstract
Any venous congestion (Venous Excess Ultrasound (VExUS) Grade ≥1 vs Grade 0)
| Test or model | AUC |
|---|---|
| SCI | 0.864 |
| IVC diameter | 0.767 |
AUC
SCI0.864
IVC diameter0.767
- SCI vs IVC diameter: P = 0.044
Further findings
| Outcome | SCI | IVC diameter |
|---|---|---|
| Correlation with venous congestion grade | ||
| Spearman's ρ | 0.691 | 0.490 |
- Correlation with venous congestion grade: both p < 0.001
Examinations without advanced venous congestion (subgroup)
- Diagnostic advantage of SCI appeared more evident
- Exploratory analyses
Disease severity
- Higher SCI values associated with greater disease severity
Original publication
Assessing venous congestion in critical illness: advantages of the inferior vena cava shape change index over diameter. Ann Intensive Care. Published 9 February 2026. doi:10.
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