{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:35:04Z","timestamp":1786649704020,"version":"build-2736575974"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Postspinal hypotension (PSH) is a common adverse event following spinal anesthesia, with a pronounced incidence among diabetic individuals due to autonomic neuropathy. This study aimed to assess the caval aorta index (IVC\/AO) and IVC collapsibility index (IVCCI) as predictors of PSH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>\n                      One hundred and twenty patients scheduled for elective surgeries under spinal anesthesia were divided into two groups: Group A (Diabetic) and Group B (nondiabetic). IVC and aorta diameters were measured to calculate the IVC\/AO index and IVCCI. Patients in both groups received spinal anesthesia using 0.5% bupivacaine (3 ml). Hemodynamic parameters were recorded, and the incidence of PSH was noted. The odds ratio for PSH was ascertained between the groups, and correlations of age, body mass index, diabetes duration, and random blood glucose levels with the IVC\/AO index were performed. Receiver operating characteristic curves were used to evaluate the diagnostic value of the IVC\/AO index and IVCCI for predicting PSH. A\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value of &lt;0.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      PSH was observed in 82 patients (68%), with 58 in group A and 24 in group B. Diabetics had a lower IVC\/AO index (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.002) and a significantly elevated IVCCI (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The IVC\/AO index of &lt;1.065 indicated an increased odds ratio (5.5) for developing PSH. A strong negative correlation was noted between the duration of diabetes and IVC\/AO index.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Preoperative ultrasonographic measurement of the IVC\/AO and IVCCI indices is a useful predictors of PSH in diabetic patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joacp.joacp_642_24","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T13:00:32Z","timestamp":1766754032000},"page":"44-49","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Caval aorta index as a predictor of hypotension after spinal anesthesia in patients with diabetes mellitus \u2013 A cross-sectional comparative study"],"prefix":"10.4103","volume":"42","author":[{"given":"Alphonse","family":"Sushmitha","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mekala","family":"RanjithKumar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stalin","family":"Vinayagam","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arumugam","family":"Vasudevan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"R1-20251226","doi-asserted-by":"crossref","first-page":"19","DOI":"10.2147\/LRA.S193925","article-title":"Spinal anesthesia-induced hypotension is caused by a decrease in stroke volume in elderly patients","volume":"12","author":"Hofhuizen","year":"2019","journal-title":"Local Reg Anesth"},{"key":"R2-20251226","doi-asserted-by":"crossref","first-page":"205","DOI":"10.3389\/fendo.2014.00205","article-title":"Autonomic neuropathy in diabetes mellitus","volume":"5","author":"Verrotti","year":"2014","journal-title":"Front Endocrinol (Lausanne)"},{"key":"R3-20251226","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.2337\/diacare.26.5.1553","article-title":"Diabetic autonomic neuropathy","volume":"26","author":"Vinik","year":"2003","journal-title":"Diabetes Care"},{"key":"R4-20251226","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1016\/j.clinthera.2022.09.002","article-title":"Cardiac autonomic neuropathy in type 1 and 2 diabetes: Epidemiology, pathophysiology, and management","volume":"44","author":"Williams","year":"2022","journal-title":"Clin Ther"},{"key":"R5-20251226","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/00000542-200603000-00022","article-title":"Heart rate variability predicts severe hypotension after spinal anesthesia","volume":"104","author":"Hanss","year":"2006","journal-title":"Anesthesiology"},{"key":"R6-20251226","doi-asserted-by":"crossref","first-page":"990","DOI":"10.4103\/ija.IJA_352_17","article-title":"Perfusion index as a predictor of hypotension following propofol induction - A prospective observational study","volume":"61","author":"Mehandale","year":"2017","journal-title":"Indian J Anaesth"},{"key":"R7-20251226","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1097\/EJA.0000000000000956","article-title":"Pre-operative ultrasonographic evaluation of inferior vena cava collapsibility index and IVC Aorta index as new predictors for hypotension after induction of spinal anaesthesia","volume":"36","author":"Salama","year":"2019","journal-title":"Eur J Anaesthesiol"},{"key":"R8-20251226","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1093\/ckj\/sfad156","article-title":"Inferior vena cava ultrasound and other techniques for assessment of intravascular and extravascular volume: An update","volume":"16","author":"Kaptein","year":"2023","journal-title":"Clin Kidney J"},{"key":"R9-20251226","doi-asserted-by":"crossref","first-page":"211","DOI":"10.4103\/JETS.JETS_154_20","article-title":"Inferior vena cava\/abdominal aorta ratio as a guide for fluid resuscitation","volume":"14","author":"Kusumastuti","year":"2021","journal-title":"J Emerg Trauma Shock"},{"key":"R10-20251226","first-page":"692","article-title":"Use of bedside ultrasound to assess fluid status: A literature review","volume":"129","author":"Piotrkowski","year":"2019","journal-title":"Pol Arch Intern Med"},{"key":"R11-20251226","first-page":"5374176","article-title":"Cardiac autonomic neuropathy: Why should cardiologists care about that?","author":"Bissinger","year":"2017","journal-title":"J Diabetes Res 2017"},{"key":"R12-20251226","doi-asserted-by":"crossref","first-page":"80","DOI":"10.4239\/wjd.v6.i1.80","article-title":"Diabetes and cardiac autonomic neuropathy: Clinical manifestations, cardiovascular consequences, diagnosis and treatment","volume":"6","author":"Balc\u0131o\u011flu","year":"2015","journal-title":"World J Diabetes"},{"key":"R13-20251226","doi-asserted-by":"crossref","first-page":"950","DOI":"10.4103\/njcp.njcp_591_18","article-title":"Correlation of sonographic inferior vena cava and aorta diameter ratio with dehydration in Nigerian children","volume":"22","author":"Adewumi","year":"2019","journal-title":"Niger J Clin Pract"},{"key":"R14-20251226","first-page":"828626","article-title":"Caval aorta index and central venous pressure correlation in assessing fluid status! \u201cUltrasound Bridging the Gap\u201d","volume":"1","author":"Sridhar","year":"2012","journal-title":"International Scholarly Research Notices 2012"},{"key":"R15-20251226","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.ajem.2016.03.058","article-title":"Ultrasound measurement of inferior vena cava collapse predicts propofol-induced hypotension","volume":"34","author":"Au","year":"2016","journal-title":"Am J Emerg Med"},{"key":"R16-20251226","doi-asserted-by":"crossref","first-page":"523","DOI":"10.4103\/ija.ija_890_22","article-title":"Efficacy of inferior vena cava collapsibility index and caval aorta index in predicting the incidence of hypotension after spinal anaesthesia- A prospective, blinded, observational study","volume":"67","author":"Lal","year":"2023","journal-title":"Indian J Anaesth"},{"key":"R17-20251226","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1097\/ALN.0000000000001002","article-title":"Inferior vena cava ultrasonography before general anaesthesia can predict hypotension after induction","volume":"124","author":"Zhang","year":"2016","journal-title":"Anesthesiology"},{"key":"R18-20251226","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1097\/ALN.0000000000001096","article-title":"Influence of diaphragmatic motion on inferior vena cava diameter respiratory variations in healthy volunteers","volume":"124","author":"Lucile","year":"2016","journal-title":"Anesthesiology"},{"key":"R19-20251226","first-page":"35","article-title":"The utility of the IVC\/Aorta diameter index in trauma patients","volume":"21","author":"Son","year":"2010","journal-title":"J Korean Soc Emerg Med"},{"key":"R20-20251226","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.ajem.2007.07.012","article-title":"Sonographic inferior vena cava\/aorta diameter index, a new approach to the body fluid status assessment in children and young adults in emergency ultrasound\u2014preliminary study","volume":"26","author":"Kosiak","year":"2008","journal-title":"Am J Emerg Med"},{"key":"R21-20251226","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1038\/nrendo.2017.151","article-title":"Global aetiology and epidemiology of type 2 diabetes mellitus and its complications","volume":"14","author":"Zheng","year":"2018","journal-title":"Nat Rev Endocrinol"}],"container-title":["Journal of Anaesthesiology Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_642_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:57:21Z","timestamp":1786647441000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_642_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,26]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/joacp.joacp_642_24","relation":{},"ISSN":["0970-9185","2231-2730"],"issn-type":[{"value":"0970-9185","type":"print"},{"value":"2231-2730","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,26]]},"assertion":[{"value":"2024-12-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}