Correlation between measured inferior vena cava diameter and right atrial pressure depends on the echocardiographic method used in patients who are mechanically ventilated

Bendjelid, Karim; Romand, Jacques-A.; Walder, Bernhard; Suter, Peter M.; Fournier, G.

doi:10.1067/mje.2002.120701

Cited by 60 publications

(36 citation statements)

References 20 publications

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“…No correlation was found between the IVC parameters and CVP under mechanical ventilation due to a basal increase in IVCD. The results are consistent with previous studies in mechanically ventilated adults 21 and neonates. 22 Because inspiration under mechanical ventilation results in an increase rather than a decrease in intrathoracic pressure, and because basal IVCD is already increased by the positive intrathoracic pressure with mechanical ventilation, the respirophasic variation of IVCD should be minimized, as shown in the present study.…”

Section: Effects Of Ventilationsupporting

confidence: 83%

Usefulness of Respiratory Variation of Inferior Vena Cava Diameter for Estimation of Elevated Central Venous Pressure in Children With Cardiovascular Disease

Iwamoto

Tamai

Kohno

et al. 2011

Circ J

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Background:The purpose of the present study was to determine the relationship of inferior vena cava diameter (IVCD) and its respirophasic variation (IVC collapsibility index: IVCCI) with central venous pressure (CVP), and thereby to provide reference cut-offs for such IVC parameters to estimate elevation in CVP in pediatric patients with cardiovascular disease. Methods and Results:The study involved consecutive pediatric patients (n=118) with various heart diseases who either had a central venous catheter in the cardiac intensive care unit or underwent cardiac catheterization. The maximum (IVCDmax) and minimum (IVCDmin) diameters of IVC were measured on ultrasound simultaneously with measurements of mean CVP. IVCDmax, IVCDmin and IVCCI correlated significantly with CVP (R 2 =0.26, 0.47 and 0.41, respectively) in spontaneously breathing patients, but not in mechanically ventilated patients. Receiver operator characteristic curve analysis indicated that IVCCI under spontaneous breathing had the best area under the curve, with sensitivity of 1.0 and specificity of 0.98 for a cut-off of 0.22 to predict elevated CVP ≥10 mmHg.Conclusions: IVCCI seems to be a useful and accurate non-invasive index for estimation of elevated CVP in pediatric patients with cardiovascular disease. (Circ J 2011; 75: 1209 - 1214

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Section: Effects Of Ventilationsupporting

confidence: 83%

Usefulness of Respiratory Variation of Inferior Vena Cava Diameter for Estimation of Elevated Central Venous Pressure in Children With Cardiovascular Disease

Iwamoto

Tamai

Kohno

et al. 2011

Circ J

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“…The rate of high-quality image acquisition (89%) was somewhat lower than previously reported (94 to 95%), but the previous studies used experienced sonographers on full echocardiographic platforms (20,32). A feasibility rate of nearly 90% given the more limited expertise and equipment used in our study is excellent and similar to previous results using an HCU in the hands of noncardiologists (28).…”

Section: Discussionsupporting

confidence: 46%

Handcarried Ultrasound Measurement of the Inferior Vena Cava for Assessment of Intravascular Volume Status in the Outpatient Hemodialysis Clinic

Brennan

Ronan

Goonewardena

et al. 2006

Clinical Journal of the American Society of Nephrology

190

133

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Accurate intravascular volume assessment is critical in the treatment of patients who receive chronic hemodialysis (HD) therapy. Clinically assessed dry weight is a poor surrogate of intravascular volume; however, ultrasound assessment of the inferior vena cava (IVC) is an effective tool for volume management. This study sought to determine the feasibility of using operators with limited ultrasound experience to assess IVC dimensions using hand-carried ultrasounds (HCU) in the outpatient clinical setting. The IVC was assessed in 89 consecutive patients at two outpatient clinics before and after HD. Intradialytic IVC was recorded during episodes of hypotension, chest pain, or cramping. High-quality IVC images were obtained in 79 of 89 patients. Despite that 89% of patients presented at or above dry weight, 39% of these patients were hypovolemic by HCU. Of the 75% of patients who left HD at or below goal weight, 10% were still hypervolemic by HCU standards. Hypovolemic patients had more episodes of chest pain and cramping (33 versus 14%, P ‫؍‬ 0.06) and more episodes of hypotension (22 versus 3%, P ‫؍‬ 0.02). The clinic with a higher prevalence of predialysis hypovolemia had significantly more intradialytic adverse events (58 versus 27%; P ‫؍‬ 0.01). HCU measurement of the IVC is a feasible option for rapid assessment of intravascular volume status in an outpatient dialysis setting by operators with limited formal training in echocardiography. There is a poor relationship between dry weight goals and IVC collapsibility. Practice variation in the maintenance of volume status is correlated with significant differences in intradialysis adverse events.

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“…Previous studies generally support the correlation of IVC diameter to CVP (1)(2)(3)(4)(5)(6)(7)25). Many of these studies, however, used complex imaging and measuring techniques such as formal transesophageal echocardiography, caval or collapsibility indices, and cine review and multiple measurements during the ventilatory cycle.…”

Section: Discussionmentioning

confidence: 92%

“…Many of these studies, however, used complex imaging and measuring techniques such as formal transesophageal echocardiography, caval or collapsibility indices, and cine review and multiple measurements during the ventilatory cycle. Studies using different ultrasound techniques have reported r values in the 0.66-0.86 range for right atrial and IVC diameter correlations (2,7,8,24,25). Surrogate markers for CVP (units of blood transfused or phlebotomized, or weight change with hemodialysis) have been used by other researchers, yielding correlations of 0.40 and 0.74, respectively (4,9,26).…”

Section: Discussionmentioning

confidence: 95%

Does a Simple Bedside Sonographic Measurement of the Inferior Vena Cava Correlate to Central Venous Pressure?

Lorenzo

Morris

Williams

et al. 2012

The Journal of Emergency Medicine

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Correlation between measured inferior vena cava diameter and right atrial pressure depends on the echocardiographic method used in patients who are mechanically ventilated

Cited by 60 publications

References 20 publications

Usefulness of Respiratory Variation of Inferior Vena Cava Diameter for Estimation of Elevated Central Venous Pressure in Children With Cardiovascular Disease

Usefulness of Respiratory Variation of Inferior Vena Cava Diameter for Estimation of Elevated Central Venous Pressure in Children With Cardiovascular Disease

Handcarried Ultrasound Measurement of the Inferior Vena Cava for Assessment of Intravascular Volume Status in the Outpatient Hemodialysis Clinic

Does a Simple Bedside Sonographic Measurement of the Inferior Vena Cava Correlate to Central Venous Pressure?

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