Diagnostic Accuracy of Vascular Ultrasonography for Postanesthesia Induction Hypotension: A Systematic Review and Network Meta-Analysis
Authors' conclusion
The predictive performance of point-of-care ultrasound for PIH is uncertain.
Study context
- Population
- Adults in noncardiac, nonobstetrical routine surgery
- Participants
- 2,631 adults · 32 studies
- Comparison
- Point-of-care ultrasound tests for predicting postinduction hypotension
- Inferior vena cava collapsibility indexn = 22 studies
- Carotid artery corrected flow timen = 2 studies
- Outcome
- Postinduction hypotension (PIH) as defined by study authors
Methodological detailsBayesian, Cochrane methodology, QUADAS-2, Grading of Recommendations Assessment, Development and Evaluation (GRADE)
- Bayesian
- Cochrane methodology
- QUADAS-2
- GRADE
Pooled result
As reported in the abstract
Predictive performance for PIH
| Group | Sensitivity | Specificity |
|---|---|---|
| Inferior vena cava collapsibility index | 60% (95% CrI, 49%-72%) | 83% (CrI, 74%-89%)Specificity on a scale from 0 to 100 percent |
| Carotid artery corrected flow time | 91% (CrI, 76%-98%)Sensitivity on a scale from 0 to 100 percent | 90% (CrI, 59%-98%)Specificity on a scale from 0 to 100 percent |
Sensitivity
Inferior vena cava collapsibility index60% (95% CrI, 49%-72%)
Carotid artery corrected flow time91% (CrI, 76%-98%)
Sensitivity on a scale from 0 to 100 percentSpecificity
Inferior vena cava collapsibility index83% (CrI, 74%-89%)
Carotid artery corrected flow time90% (CrI, 59%-98%)
Specificity on a scale from 0 to 100 percentFurther pooled results
Risk of bias and certainty of evidence
- Serious bias and applicability concerns (selection bias, inappropriate blinding)
- Certainty of evidence very low for all tests
Original publication
Diagnostic Accuracy of Vascular Ultrasonography for Postanesthesia Induction Hypotension: A Systematic Review and Network Meta-Analysis. Anesth Analg. Published 6 June 2025. doi:10.
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