Inferior Vena Cava Measurement with Ultrasound: What Is the Best View and Best Mode?

Finnerty, Nathan M.; Panchal, Ashish R.; Boulger, Creagh; Vira, Amar; Bischof, Jason J.; Amick, Christopher; Way, David P.; Bahner, David P.

doi:10.5811/westjem.2016.12.32489

Cited by 83 publications

(55 citation statements)

References 27 publications

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“…Although inter‐rater variability for the CVC CI may be high in healthy dogs, it is possible that CVC measurements at this location will have less inter‐rater variability when measured in hypervolemic or hypovolemic dogs. In humans, the greatest variation of IVC CI occurs in healthy populations, with less variation occurring in patients with values outside established reference intervals . However, IVC CI still is widely used in humans in critical care units to determine intravascular status.…”

Section: Discussionmentioning

confidence: 99%

“…In humans, the greatest variation of IVC CI occurs in healthy populations, 34 with less variation occurring in patients with values outside established reference intervals. 35 In human medicine, the IVC/Ao often is used to assess intravascular volume because it can be used in patients with various weights and body sizes.…”

Section: Reference Values For Echocardiographic Dimensions Related mentioning

confidence: 99%

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Establishment of reference values of the caudal vena cava by fast‐ultrasonography through different views in healthy dogs

Darnis

Boysen

Merveille

et al. 2018

Veterinary Internal Medicne

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BackgroundClinical assessment of intravascular volume status is challenging. In humans, ultrasonographic assessment of the inferior vena cava diameter, directly or as a ratio to the aortic diameter is used to estimate intravascular volume status.ObjectivesTo ultrasonographically obtain reference values (RV) for caudal vena cava diameter (CVCD), area (CVCa) and aortic ratios using 3 views in awake healthy dogs.AnimalsOne hundred and twenty‐six healthy adult dogs from clients, students, faculty, or staff.MethodsProspective, multicenter, observational study. Two observer pairs evaluated CVCD by a longitudinal subxiphoid view (SV), a transverse 11th‐13th right hepatic intercostal view (HV), and a longitudinal right paralumbar view (PV). Inter‐rater agreements were estimated using concordance correlation coefficients (CCC). For body weight (BW)‐dependent variables, RVs were calculated using allometric scaling for variables with a CCC ≥ 0.7.ResultsThe CCC was ≤0.43 for the CVC/aorta ratio at the PV and ≤0.43 in both inspiration and expiration for CVC at the SV. The RVs using allometric scaling for CVCa at the HV for inspiration, expiration, and for CVCD at the PV were 6.16 × BW0.762, 7.24 × BW0.787, 2.79 × BW0.390, respectively.Conclusions and Clinical ImportanceThe CVCD, measured at the HV and PV in healthy awake dogs of various breeds has good inter‐rater agreement suggesting these sites are reliable in measuring CVCD. Established RVs for CVCD for these sites need further comparison to results obtained in hypovolemic and hypervolemic dogs to determine their usefulness to evaluate volume status in dogs.

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Section: Discussionmentioning

confidence: 99%

Section: Reference Values For Echocardiographic Dimensions Related mentioning

confidence: 99%

Establishment of reference values of the caudal vena cava by fast‐ultrasonography through different views in healthy dogs

Darnis

Boysen

Merveille

et al. 2018

Veterinary Internal Medicne

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“…Another way to estimate an individual's intravascular filling state non‐invasively is the ultrasound derived inferior vena cava collapsibility index (IVCI) (Finnerty et al . ). In intensive care patients, IVCI correlates well with invasively measured central venous pressure and pulmonary artery pressure (Stawicki et al .…”

Section: Cardiorenal Syndromesmentioning

confidence: 97%

“…In contrast, plasma volume (PV) expansion is known to be less pronounced in preeclampsia than in uncomplicated pregnancy (De Haas et al 2017), but increased PV has also been reported in late preeclampsia (Friedberg & Lutz, 1963;Schrier & Briner, 1991) with or without persistence of high cardiac output (Easterling et al 1990;Bosio et al 1999). Another way to estimate an individual's intravascular filling state non-invasively is the ultrasound derived inferior vena cava collapsibility index (IVCI) (Finnerty et al 2017). In intensive care patients, IVCI correlates well with invasively measured central venous pressure and pulmonary artery pressure (Stawicki et al 2016;Ilyas et al 2017).…”

Section: Direct Cardiorenal Interactionsmentioning

confidence: 99%

Preeclampsia: a gestational cardiorenal syndrome

Gyselaers

Thilaganathan

2019

The Journal of Physiology

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It is generally accepted today that there are two different types of preeclampsia: an early‐onset or placental type and a late‐onset or maternal type. In the latent phase, the first one presents with a low output/high resistance circulation eventually leading in the late second or early third trimester to an intense and acutely aggravating systemic disorder with an important impact on maternal and neonatal mortality and morbidity; the other type presents initially as a high volume/low resistance circulation, gradually evolving to a state of circulatory decompensation usually in the later stages of pregnancy, with a less severe impact on maternal and neonatal outcome. For both processes, numerous dysfunctions of the heart, kidneys, arteries, veins and interconnecting systems are reported, most of them presenting earlier and more severely in early‐ than in late‐onset preeclampsia; however, some very specific dysfunctions exist for either type. Experimental, clinical and epidemiological observations before, during and after pregnancy are consistent with gestation‐induced worsening of subclinical pre‐existing chronic cardiovascular dysfunction in early‐onset preeclampsia, and thus sharing the pathophysiology of cardiorenal syndrome type II, and with acute volume overload decompensation of the maternal circulation in late‐onset preeclampsia, thus sharing the pathophysiology of cardiorenal syndrome type 1. Cardiorenal syndrome type V is consistent with the process of preeclampsia superimposed upon clinical cardiovascular and/or renal disease, alone or as part of a systemic disorder. This review focuses on the specific differences in haemodynamic dysfunctions between the two types of preeclampsia, with special emphasis on the interorgan interactions between heart and kidneys, introducing the theoretical concept that the pathophysiological processes of preeclampsia can be regarded as the gestational manifestations of cardiorenal syndromes.

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“…Additionally, Caval sonography can be repeated during fluid resuscitation to follow up improvement of these parameters. With B-mode holds the most promise to deliver reliable measures of IVC diameter 26 . The IVC diameter of more than 2.5 cm and minimal collapse (<10%) correlates with raised right atrial pressure >15mm Hg 27 .…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Transhepatic Ultrasonic Evaluation of Inferior Vena Cava Diameter to Guide Fluid Management in Comparison With Anterior Approach

A¹,

A²,

A³

2018

Basrah Journal of Surgery

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Non-invasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava using ultrasound machines is nowadays promising with the increasing availability of these machines in emergency departments, critical care units and in operating theaters. The learning curve of these tools is steep and they are becoming less expensive and give quick, noninvasive, dynamic clue to the preload status. The aim of this study is to evaluate the transhepatic inferior vena cava (IVC) diameter by noninvasive sonographic imaging and compare it with that measured by subxiphoid approach to reveal the degree of agreement between them. This is a prospective study, done in a tertiary care referral hospital at intensive care unit in Al-Sadr Teaching Hospital over a period of four months from 1st February 2017 to 5th of June 2017. Eighty shocked patients were included for assessment of volume status. Bedside ultrasound images were obtained with the patient in supine position to determine the dimensions and collapsibility of IVC. Evaluation of each patient included the standard anterior subxiphoid IVC assessment and lateral transhepatic assessment of IVC by ultrasound using liver as an acoustic window in mid-axillary line. The IVC diameter was measured 2 cm caudal to the hepatic vein-IVC junction, or approximately 3-4 cm caudal to the junction of IVC and the right atrium. Then IVC maximal diameter, IVC minimal diameter and collapsibility index were calculated for both approaches. A comparison between these data was made. A total of eighty patients were included, 31 (37.5%) were females and 49 (62.5%) were males. Mean age was 45.81±14.89 years. The results showed that there is no statistically significant difference between transhepatic and subxiphoid approaches in regard to IVC diameter and its collapsibility. In conclusion, transhepatic lateral view of IVC provides a good alternative when subxiphoid anterior view cannot be obtained to guide fluid management in shocked patients.

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Inferior Vena Cava Measurement with Ultrasound: What Is the Best View and Best Mode?

Cited by 83 publications

References 27 publications

Establishment of reference values of the caudal vena cava by fast‐ultrasonography through different views in healthy dogs

Establishment of reference values of the caudal vena cava by fast‐ultrasonography through different views in healthy dogs

Preeclampsia: a gestational cardiorenal syndrome

Feasibility of Transhepatic Ultrasonic Evaluation of Inferior Vena Cava Diameter to Guide Fluid Management in Comparison With Anterior Approach

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