Inferior Vena Cava Ultrasonography for Volume Status Evaluation: An Intriguing Promise Never Fulfilled

Nicolò, Pierpaolo Di; Tavazzi, Guido; Nannoni, Luca; Corradi, Francesco

doi:10.3390/jcm12062217

Cited by 33 publications

(21 citation statements)

References 76 publications

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“…Additionally, patients with severe cardiomyopathy (either acute or chronic), right ventricular failure, cardiogenic shock, severe pulmonary hypertension have been routinely excluded from population investigated and represents pitfalls of IVC evaluation [43]. Therefore, protocols and algorithm using the IVC as a main driver for the evaluation of the organ congestion/volume assessment in cardiocirculatory failure patients must be cautiously applied [44 ▪ ].…”

Section: Thoracic Ultrasoundmentioning

confidence: 99%

Multimodality imaging in cardiogenic shock: state-of-the art

Tavazzi

Corradi

Vandenbriele

et al. 2023

Current Opinion in Critical Care

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Purpose of review There is emerging evidence on the role of the multimodality imaging in the setting of cardiogenic shock. The utility of different imaging modalities, along with their pitfalls and limitations, and their integration in a multiparametric approach are discussed in the current review. Recent findings The evaluation of congestion and perfusion in patients with shock has allowed a better understanding of the underlying physiopathological mechanisms. Integration of echocardiography, using more physiological parameters, with lung ultrasound, as well as the Doppler evaluation of abdominal blood flow dynamics, has led to a better stratification in patinas with hemodynamic instability. Summary Although validation of the integrated approaches and single parameters are needed, the physiopathological-driven approach using ultrasound in patients with cardiogenic shock on top of the clinical and biochemical evaluation, may aid to a quicker and more detailed evaluation of patient's phenotype.

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Section: Thoracic Ultrasoundmentioning

confidence: 99%

Multimodality imaging in cardiogenic shock: state-of-the art

Tavazzi

Corradi

Vandenbriele

et al. 2023

Current Opinion in Critical Care

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“…[65][66][67] However, more recent literature suggests that the use of IVC ultrasound is burdened by technical limitations and errors in interpretation. 68 As an advanced sonographer, one should be aware of these limitations. and TDI of the mitral annulus (E' wave).…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies have demonstrated the accuracy and reliability of inferior vena cava (IVC) ultrasound in assessing fluid status and guiding fluid management decisions 65‐67 . However, more recent literature suggests that the use of IVC ultrasound is burdened by technical limitations and errors in interpretation 68 . As an advanced sonographer, one should be aware of these limitations.…”

Section: Discussionmentioning

confidence: 99%

The 2023 Core Content of advanced emergency medicine ultrasonography

Adhikari,

Leo,

Liu

et al. 2023

JACEP Open

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In February 2023, the American Board of Emergency Medicine (ABEM) approved modifications to the Advanced Emergency Medicine Ultrasonography (AEMUS) Core Content, which defines the areas of knowledge considered essential for the practice of AEMUS. This manuscript serves as a revision of the AEMUS Core Content originally published in 2014. The revision of the Core Content for AEMUS training aims to establish standardized education and qualifications necessary for AEMUS fellowship program leadership, clinical application, administration, quality improvement, and research. The Core Content provides the organizational framework and serves as the basis for the development of content for the Focused Practice Examination (FPE) administered by ABEM. AEMUS fellowship directors may reference the Core Content when designing AEMUS fellowship curricula to help prepare graduates for the autonomous practice of AEMUS and the FPE. In this article, an updated revision of the previously published AEMUS Core Content is detailed, and the entire development of the Core Content is presented.

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“…The subcostal sagittal view of the IVC has become an essential component of the POCUS examination in critically ill patients. It can provide vital information regarding intravascular volume status and estimation of right atrial pressure in select patients, and while it has traditionally been used for evaluation of volume responsiveness prediction, accurate prediction using IVC can be fraught with challenges and there is significant heterogeneity in the literature regarding its use (18)(19)(20)(21)(37)(38)(39)(40)(41). It may be more reasonable to use IVC dimensions as well as the extremes of its collapsibility or distensibility index to improve diagnostic accuracy to rule in/out a patient who may be volume responsive.…”

Section: Inadequate Subcostal Windows: the Inferior Vena Cavamentioning

confidence: 99%

Point-of-Care Echocardiography in the Difficult-to-Image Patient in the ICU: A Narrative Review

Grotberg,

McDonald,

2024

Critical Care Explorations

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OBJECTIVES: The objective of this narrative review was to address common obstacles encountered in the ICU to acquiring quality and interpretable images using point-of-care echocardiography. DATA SOURCES: Detailed searches were performed using PubMed and Ovid Medline using medical subject headings and keywords on topics related to patient positioning, IV echo contrast, alternative subcostal views, right ventricular outflow tract (RVOT) hemodynamics, and point-of-care transesophageal echocardiography. Articles known to the authors were also selected based on expert opinion. STUDY SELECTION: Articles specific to patient positioning, IV echo contrast, alternative subcostal views, RVOT hemodynamics, and point-of-care transesophageal echocardiography were considered. DATA EXTRACTION: One author screened titles and extracted relevant data while two separate authors independently reviewed selected articles. DATA SYNTHESIS: Impediments to acquiring quality and interpretable images in critically ill patients are common. Notably, body habitus, intra-abdominal hypertension, dressings or drainage tubes, postoperative sternotomies, invasive mechanical ventilation, and the presence of subcutaneous emphysema or lung hyperinflation are commonly encountered obstacles in transthoracic image acquisition in the ICU. Despite these obstacles, the bedside clinician may use obstacle-specific maneuvers to enhance image acquisition. These may include altering patient positioning, respiratory cycle timing, expanding the subcostal window to include multilevel short-axis views for use in the assessment of RV systolic function and hemodynamics, coronal transhepatic view of the inferior vena cava, and finally point-of-care transesophageal echocardiography. CONCLUSIONS: Despite common obstacles to point-of-care echocardiography in critically ill patients, the beside sonographer may take an obstacle-specific stepwise approach to enhance image acquisition in difficult-to-image patients.

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Inferior Vena Cava Ultrasonography for Volume Status Evaluation: An Intriguing Promise Never Fulfilled

Cited by 33 publications

References 76 publications

Multimodality imaging in cardiogenic shock: state-of-the art

Multimodality imaging in cardiogenic shock: state-of-the art

The 2023 Core Content of advanced emergency medicine ultrasonography

Point-of-Care Echocardiography in the Difficult-to-Image Patient in the ICU: A Narrative Review

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