Effect of positional changes on inferior vena cava size

“…We speculated that the compression of the IVC by the liver might be followed by a decreased venous return in the left recumbent position, although our results showed no effect of the position on blood volume in the IVC. In this study, the hemodynamics in the IVC were recorded at a site 1 cm distal to the hepatic vein, and Mookadam et al (2011) found using echography that the blood volume returning from the liver to the heart between the supine and the left recumbent positions was almost unchanged. Therefore, these findings including our present study suggest that the left recumbent position has no influence on venous return as an index of preload.…”

Section: Hemodynamics In the Heart And Inferior Vena Cava In Recumbenmentioning

confidence: 87%

Left Recumbent Position Decreases Heart Rate without Alterations in Cardiac Autonomic Nervous System Activity in Healthy Young Adults

Sasaki

Haga

Endo

et al. 2017

Tohoku J. Exp. Med.

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Some studies have reported that recumbent position may have advantages in patients with heart disease and in pregnancy. However, it remains controversial whether recumbent position affects autonomic nervous system activity and hemodynamics in healthy adults. The aim of this study was to evaluate alterations in heart rate variability (HRV) and hemodynamics in the supine, left recumbent and right recumbent positions in healthy young adults. A total of 80 participants aged 22.8 ± 3.1 years were enrolled in this observational study. Fifty-eight volunteers (29 men and 29 women) maintained the supine position followed by the left and right recumbent positions, while electrocardiographic data were recorded for spectral analysis of HRV to assess cardiac vagal nerve and sympathetic nerve activities. The heart rate (HR) was significantly lower in the left recumbent position than in the other positions. There were no statistically significant differences in HRV among the three positions. Considering the possibility that the echographic procedure affects autonomic nervous system (ANS) activity, the other 22 participants (11 men and 11 women) underwent an echographic evaluation of hemodynamics in the heart and inferior vena cava (IVC) across the three positions. Although a low HR was also observed, there were no statistically significant differences in the IVC or the heart blood volume between the supine and the left recumbent positions. A postural change to the left recumbent position does not affect the cardiac blood circulation or ANS activity, though it does decrease HR in healthy young adults. This finding indicates that the lower HR in the left recumbent position is not attributable to the ANS activity.

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“…3,4 It has been shown that the extent of respiratoryinduced changes in the inferior vena cava (IVC) diameter in ventilated septic patientsdistensibility or extensibility, in contrast to collapsibility in spontaneously breathing patientscan predict responsiveness to volume expansion. Due to the great compliance of central venous vessels, they can be distended by intra-thoracic pressure fluctuations during respiration/ventilation, as well as the patient's position.…”

Section: Editorial Comment: What This Article Tells Usmentioning

confidence: 99%

Is internal jugular vein extensibility associated with indices of fluid responsiveness in ventilated patients?

Thudium

Klaschik

Ellerkmann

et al. 2016

Acta Anaesthesiol Scand

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Effect of positional changes on inferior vena cava size

Cited by 35 publications

References 10 publications

COUNTERPOINT: Should Acute Fluid Resuscitation Be Guided Primarily by Inferior Vena Cava Ultrasound for Patients in Shock? No

COUNTERPOINT: Should Acute Fluid Resuscitation Be Guided Primarily by Inferior Vena Cava Ultrasound for Patients in Shock? No

Left Recumbent Position Decreases Heart Rate without Alterations in Cardiac Autonomic Nervous System Activity in Healthy Young Adults

Is internal jugular vein extensibility associated with indices of fluid responsiveness in ventilated patients?

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